Sir.—Central nervous system disease secondary to vaccine poliovirus infection is a well-documented phenomenon both in immunocompromised children and in the normal host.1,2 Myocarditis and pneumonitis have not been previously reported as a consequence of vaccinelike strains, to our knowledge, and a diffuse encephalomyelitis is rare. We herein describe a 5-month-old infant who developed multiple organ dysfunction secondary to infection by vaccine poliovirus type 2 acquired by household exposure.
Report of a Case.—A 5-month-old male infant presented with failure to thrive and respiratory distress after receiving a regimen of nasal betamethasone dipropionate, 1 mg/d, for three months, which had been prescribed by a local physician for nasal congestion. Recurrent bilateral otitis media, oral thrush, and a monilial rash had become persistent problems. A temperature of 40.6°C accompanied by marked respiratory distress necessitated admission to our hospital. Significant history included the fact that two family members, both children, had