Imaging of congenital Zika virus infection: the route to identification of prognostic factors

Abstract

Zika virus (ZIKV) has recently emerged as a novel teratogenic agent associated with severe neurological complications. The risk associated with maternal infection remains to be exactly defined but appears to be significant. Like other TORCH agents (toxoplasmosis, other agents, rubella, cytomegalovirus and herpes simplex), it is unlikely that all affected fetuses will be symptomatic at birth. It is therefore urgent to better define the spectrum of anomalies observed in infected fetuses to provide adequate parental counseling. In this review, we provide a comprehensive analysis of major cases described to date and highlight specific prenatal and postnatal radiological findings of congenital ZIKV infection. A total of 19 reports were included in our analysis. ZIKV seemed to harbor a specific tropism for the central nervous system, and anomalies were mostly limited to the brain. Major radiological findings were ventriculomegaly, diffuse calcifications and signs of abnormal gyration as well as cortical development. In addition, a significant number of fetuses suffered from intra uterine growth restriction. Based on these findings, we provide recommendations for adequate radiological monitoring of at-risk pregnancies. © 2016 John Wiley & Sons, Ltd.

Spectrum of Spinal Cord, Spinal Root, and Brain MRI Abnormalities in Congenital Zika Syndrome with and without Arthrogryposis

“…It is difficult to determine the prognosis of the different degrees of the congenital Zika syndrome due to the lack of follow-up studies 29 ; however, congenital Zika virus infection with severe brain damage should have a poor prognosis. 29 Knowledge of the spectrum of this syndrome can be helpful in identifying which cases could have higher chances of worse outcomes.…”

“…29 Knowledge of the spectrum of this syndrome can be helpful in identifying which cases could have higher chances of worse outcomes. It is probable that infants with arthrogryposis will have worse prognoses, especially in motor development, even if they do not have severe brain lesions or microcephaly.…”

Zika virus: A new threat to human reproduction

“…21 Imaging, case reports, cohort studies have allowed to build a consensus that ZIKV infection can cause a so-called congenital Zika syndrome which is not limited to microcephaly but also include birth defects such as craniofacial disproportion, brainstem dysfunction, ocular anomalies, and auditory dysfunctions. [22][23][24][25][26] …”

“…Of note, cryptorchidia, hypospadias, and micropenis have been described in newborns from infected mothers. 14,24,49 The presence of ZIKV in cervical mucus raises the same question as in the male genital tract. 44 Murray et al 50 recently observed prolonged detection of ZIKV RNA in vaginal mucosal swab specimens and whole blood for a US traveler with acute ZIKV infection who had visited Honduras.…”

Zika Virus, Congenital Infection, and Neurologic Manifestations in Children: A Narrative Review

“…The most common CNS abnormalities of the fetus are ventriculomegaly, microcephaly, and intracranial calcification, especially at the gray-white matter junction (48,49). The prevalence of microcephaly due to ZIKV infection in the first trimester of pregnancy ranges from 0.88% to 13.2% (50).…”