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Vaccine-associated paralytic poliomyelitis and BCG-osis in an immigrant child with severe combined immunodeficiency syndrome - Texas, 2013.
[severe combined immunodeficiency]
Poliovirus
transmission
has
been
eliminated
in
most
of
the
world
through
the
use
of
inactivated
poliovirus
vaccine
(
IPV
)
and
live
,
attenuated
oral
poliovirus
vaccine
(
OPV
)
.
In
the
United
States
,
use
of
OPV
was
discontinued
by
the
year
2000
because
of
the
potential
for
vaccine-associated
paralytic
polio
(
VAPP
)
;
an
average
of
eight
cases
were
reported
each
year
in
the
United
States
during
1980
-
2000
.
Polio
eradication
efforts
in
other
parts
of
the
world
continue
to
rely
on
OPV
to
take
advantage
of
transmission
of
poliovirus
vaccine
strains
to
unvaccinated
persons
in
the
population
,
lower
cost
,
and
ease
of
administration
.
In
2013
,
an
infant
aged
7
months
who
recently
immigrated
to
the
United
States
from
India
was
referred
to
a
hospital
in
San
Antonio
,
Texas
.
The
infant
had
fever
,
an
enlarging
skin
lesion
in
the
deltoid
region
with
axillary
lymphadenopathy
,
decreased
activity
,
and
inability
to
bear
weight
on
the
left
leg
,
progressing
to
paralysis
of
the
left
leg
over
a
6
-
week
period
.
Recognition
of
lymphopenia
on
complete
blood
count
led
to
immune
evaluation
,
which
revealed
the
presence
of
severe
combined
immunodeficiency
syndrome
(
SCIDS
)
,
an
inherited
disorder
.
A
history
of
OPV
and
bacille
Calmette-
Guérin
(
BCG
)
vaccination
in
India
led
to
the
diagnoses
of
VAPP
and
BCG-osis
,
which
were
confirmed
microbiologically
.
This
report
demonstrates
the
importance
of
obtaining
a
comprehensive
clinical
history
in
a
child
who
has
recently
immigrated
to
the
United
States
,
with
recognition
that
differing
vaccine
practices
in
other
countries
might
require
additional
consideration
of
potential
etiologies
.
Diseases
Validation
Diseases presenting
"blood count"
symptom
alpha-thalassemia
classical phenylketonuria
familial mediterranean fever
heparin-induced thrombocytopenia
holt-oram syndrome
oculocutaneous albinism
pyomyositis
severe combined immunodeficiency
wiskott-aldrich syndrome
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