Six days before his death, this 31-year-old white male became acutely ill with fever followed by an ascending paralysis which began in his feet. Three days later he was hospitalized because of difficulty in breathing. A lumbar puncture was performed and the patient's spinal fluid contained increased protein and polymorphonuclear leukocytes (4.30 PMNs/mm³). He died on the third hospital day.
At autopsy, the thoracic and lumbar portions of the spinal cord were softer than normal and focally hemorrhagic.
Normal Spinal Cord
Poliovirus replicates inside neurons and causes lysis of the cell.
Poliovirus is an enterovirus that is usually acquired from contaminated water. It has been effectively controlled by immunization; however, among the nonimmune it causes a nonspecific gastroenteritis. In a small fraction of the vulnerable population, it can invade the nervous system where it attacks lower motor neurons.
- eMedicine Medical Library: Pediatric Poliomyelitis
- Merck Manual: Poliomyelitis
- The WHO: Global Polio Eradication Initiative
- Alexander L, Birkhead G, Guerra F, Helms C, Hinman A, Katz S, LeBaron CW, Modlin J, Murphy TV; National Vaccine Advisory Committee-Advisory Committee on Immunization Practices Joint Working Group; Centers for Disease Control and Prevention. Ensuring preparedness for potential poliomyelitis outbreaks: recommendations for the US poliovirus vaccine stockpile from the National Vaccine Advisory Committee (NVAC) and the Advisory Committee on Immunization Practices (ACIP). Arch Pediatr Adolesc Med 2004 Dec;158(12):1106-12.
- PEIR Digital Library: Polio Images
- WebPath: CNS Pathology: Acquired and Congenital Degenerative Diseases
Normally, there should be no PMNs in a patient's spinal fluid.
An infiltrate is an accumulation of cells in the lung parenchyma--this is a sign of pneumonia.