Zika Virus Infection Presenting with Postauricular Lymphadenopathy

Abstract

A 28-year-old, otherwise healthy Chilean man presented in December 2015 with fever, headache, and myalgia. He had returned, 2 days ago, from a tourist trip to Colombia, where he had visited Bogota and the northern region including Cartagena de Indias, Santa Marta, and Tayrona National Park. During his return, he suffered nonspecific symptoms including sore throat, anorexia, and myalgia. A day later, he noted high grade fever and tender nodules behind his ears (Figure 1 ). Physical examination revealed fever (39.0°C), a maculopapular rash of the trunk and extremities (Figure 2 ), mild conjunctivitis, and a generalized lymphadenopathy with palpable tender axillary, cervical, and bilateral postauricular lymph nodes. After dengue and chikungunya virus infections were excluded by molecular methods, antigen detection, and IgM antibody testing, samples were sent to the national reference laboratory (Instituto de Salud Pública de Chile, Santiago, Chile), where Zika virus (ZIKV) nucleic acids were detected by real-time reverse transcription polymerase chain reaction (RT-PCR) as previously described.1 The sample was also positive using a commercial RT-PCR assay for the detection of ZIKV (Zika Virus genesig® Advanced Kit; Primerdesign™ Ltd., Southampton, United Kingdom) in the clinical laboratory, Clínica Alemana, Santiago. The patient recovered rapidly and without complications.