Computed Tomographic Findings in Microcephaly Associated with Zika Virus
Date
2016-06Author
Hazin, Adriano N.
Poretti, Andrea
Cruz, Danielle Di Cavalcanti Souza
et al.
Metadata
Show full item recordAbstract
Zika virus (ZIKV) is a mosquito-borne flavivirus that is transmitted primarily by Aedes aegypti mosquitoes.1 Starting in May 2015, an outbreak of ZIKV infection has been reported in Brazil in association with an increasing number of neonates with congenital microcephaly in ZIKV-affected regions.1 In these areas, the prevalence of congenital microcephaly increased by a factor of 20 over the prevalence before the outbreak.1 ZIKV RNA has been identified in the brain of a fetus with congenital microcephaly.2 In addition, ZIKV RNA was identified in the amniotic fluid of two women whose fetuses had congenital microcephaly detected on prenatal ultrasonography.1 These events and observations prompted concern about the possible association between congenital microcephaly and the recent outbreak of ZIKV infection in Brazil.3 Only limited imaging data about the brain anomalies that may be associated with intrauterine ZIKV infection are available.
We report findings obtained by means of head computed tomography (CT) in 23 infants (13 female) with congenital microcephaly in which the clinical and epidemiologic data are compatible with congenital ZIKV infection in the Pernambuco state of Brazil. Head CTs were obtained for clinical reasons between September and December 2015. Samples of cerebrospinal fluid were available for serologic testing in 7 of the 23 infants, and results on enzyme-linked immunosorbent assay for ZIKV IgM antibody were positive in all 7 samples. Findings on serologic analysis regarding TORCH infection (toxoplasmosis, other [syphilis, varicella, parvovirus, and human immunodeficiency virus], rubella, cytomegalovirus, and herpes simplex) were negative in all 23 infants.