Acute flaccid paralysis on 11 years old child in Bali: a case report

Abstract

Introduction: As medical professionals, we need to be aware of cases of acute flaccid paralysis, known as the current outbreak of polio infections in Indonesia. Polio is a highly contagious illness that primarily affects children under five. It can result in death (2-10% of those who were paralyzed) or lifelong paralysis (about 1 in 200 infections). The virus spreads from person to person mostly by the fecal-oral pathway. Contaminated foods and water are also less common routes of transmission. After the virus grows in the gut, it can enter the nerve system and paralyze people. Though it may vary from 4 to 35 days, the duration of incubation is typically 7 to 10 days. Approximately ninety percent of infected individuals either show no symptoms at all or have minor ones, hence the illness is typically not diagnosed. The purpose of this case report is to describe a case of acute flaccid paralysis and increase our awareness about the current polio outbreak. The Case: Eleven-year-old Korean child weighing 41 kg arrived to the clinic complaint of weakness in both limbs for the past five days. It happened throughout the day, particularly during the morning, and was felt abruptly. He also had instability when walking and trembling in both legs. He also experienced three episodes of watery diarrhea that day. In addition, he reported having puked twice in the two days before his clinic appointment. His calves had a motoric grade of 3 and a grade of 5 on his soles, indicating that his calves were weaker than his soles. It was discovered that the muscular tone was weak. No evidence of muscular atrophy was present. Positive tripod indication was seen. There were no abnormalities in sensibility. He was diagnosed with acute flaccid paralysis et causa suspected poliomyelitis dd Guillain Barre Syndrome dd hypokalemia paralysis et causa diarrhea and vomiting. Conclusion: Facing the polio outbreak in Indonesia, this case would serve as an example to raise awareness of acute flaccid paralysis cases, enabling early detection, differential diagnosis exclusion, and effective surveillance.