A 2-year-old child in a tribal area develops flaccid monoplegia of the left leg following a febrile illness 3 weeks ago. No muscle wasting is noted yet. CSF shows 60 cells (predominantly lymphocytes), normal glucose, mildly elevated protein. The most appropriate confirmatory diagnostic step is:
- A MRI spine with gadolinium
- B Serum polio IgM ELISA
- C Two stool samples for poliovirus isolation sent to national reference laboratory ✓
- D EMG to confirm lower motor neuron lesion
Correct answer: C. Two stool samples for poliovirus isolation sent to national reference laboratory
Explanation
Acute flaccid paralysis (AFP) is a notifiable condition in India; the gold standard for confirming poliovirus is isolation of poliovirus from two stool samples collected 24–48 hours apart and within 14 days of paralysis onset, sent to an accredited WHO laboratory. Serum IgM is unreliable for diagnosis. MRI spine can show anterior horn cell involvement but is not confirmatory for virus isolation. EMG confirms lower motor neuron pattern but does not identify the etiology.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.