Brucellosis simulating acute anterior poliomyelitis

Abstract

The diagnosis of acute anterior poliomyelitis in the paralytic stage is usually easy, provided that one obtains a reliable history and is able to carry out an unhurried and unharried examination. In my experience the only difficult cases were those with isolated facial paralysis. In recent years (and thirty years is recent to me!) poliomyelitis has become surrounded with an aura of dread and apprehension-an atmosphere not conducive to cool and objective judgment. The parents, alarmed by anything which might indicate" polio", give a confused history. The practitioner himself is easily affected by the general panic and is further influenced by the fear of missing a case. Under these circumstances any suspicion of inability or even reluctance to move a limb, a mere limp, or the slightest difficulty in standing are all likely to be pounced upon as signs of paralysis without a complete examination and full consideration of other possibilities. The unfortunate patient is rushed off to hospital as a definite or as a suspected case. This applies particularly to Malta, where the disease is notifiable and isolation is insisted upon.