Clinical and laboratory diagnosis of congenital Zika virus syndrome and diaphragmatic unilateral palsy: case report

Abstract

Introduction: several birth defects associated to congenital Zika virus infection have been reported, although the clinical features have not been fully characterized. Description: this is the first case report on unilateral diaphragmatic paralysis diagnosed on a neonate with congenital Zika confirmed by the examination of the amniotic fluid through polymerase chain reaction (ZIKV RT-PCR) and the examination of cerebrospinal fluid by serological test (IgM ZIKV-ELISA) after birth. The main manifestations detected by intrauterine ultrasound were: microcephaly, ventriculomegaly, intracranial calcifications, enlarged cisterna magna, increased amniotic fluid index and fetal akinesia syndrome. The newborn had acute respiratory failure in the first hours of life, requiring mechanical ventila-tion. The X- ray of the chest showed unilateral diaphragmatic paralysis and cardiomegaly. Discussion: diaphragmatic palsy in congenital Zika has not been previously reported, the etiopathogenic mechanisms of this event in congenital Zika virus needs to be elucidated.

Nutritional profile of newborns with microcephaly and factors associated with worse outcomes

“…Calcification and severe microcephaly were associated with lower z-scores during hospitalization. Patients who had other alterations, such as ventriculomegaly, mega cisterna magna and cerebellar hypoplasia, as identified in studies that addressed ZIKV Congenital Syndrome (25,26), also had lower mean z-scores, although the difference was not statistically significant. However, newborns with hydrocephalus, a condition characterized by the accumulation of cerebrospinal fluid in the cerebral ventricles and the subarachnoid space (27), showed predominantly higher mean z-scores during the period evaluated.…”

Palliative Care in Congenital Syndrome of the Zika Virus Associated with Hospitalization and Emergency Consultation: Palliative Care and Congenital Syndrome of Zika

“…The hospitalizations occurred to perform invasive procedures (9.7%) such as VPS implantation, gastrostomy, or orthopedic surgeries due to complications inherent to the basis disease. Respiratory infections accounted for 4.1% of hospitalizations of these children, understood as possible consequences of bronchoaspirations due to neurological disorders and swallowing [ 13 , 15 – 17 ]. As observed in other studies, this pattern of complications would be expected for these children; however, the high number of hospitalizations and invasive procedures stands out [ 13 , 15 – 17 ].…”

“…CSZV has become a clinical condition associated with several complications, with a disabling and noncurable nature [ 16 – 21 ]. Among the malformations described in the literature are cerebral atrophy, absence of brain spins, craniofacial disproportion, cerebral calcifications, corpus callosum and cerebellar vermis dysgenesis, limb contractures, arthrogryposis, and auditory and ocular abnormalities [ 7 , 17 , 18 ].…”

Aedes Aegypti E Arboviroses No Brasil

“…Após o nascimento, o bebê entrou em falência respiratória necessitando de auxílio de ventilação mecânica. Assim sendo, a paralisia diafragmática traz à tona a necessidade da investigação mais aprofundada dos mecanismos da infecção congênita causada pelo Zika vírus (SOUZA et al, 2016b).…”