Neuroimaging findings of Zika virus infection: a review article

Mehrjardi, Mohammad Zare; Keshavarz, Elham; Poretti, Andrea; Hazin, Adriano Nassri

doi:10.1007/s11604-016-0588-5

Cited by 332 publications

(71 citation statements)

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“…On the other hand, the majority of fetuses/neonates with congenital Zika infection have abnormal neuroimaging findings including microcephaly, intracranial calcifications, malformations of cortical development (mostly polymicrogyria), cerebellar and brainstem hypoplasia, ventriculomegaly, agenesis/ hypoplasia of the corpus callosum, absent cavum septum pellucidum, white matter changes most likely due to dysmyelination, and ocular abnormalities. These findings may be detected in the prenatal or neonatal imaging studies [2,3,5].In conclusion, when discussing neuroimaging findings in Zika virus infection, it is extremely important to differentiate between congenital and acquired infection. Our review article focused mainly on congenital ZIKV infection, which is associated with abnormal neuroimaging findings Dear Editor, We appreciate the interest on our article by Prof. Viroj Wiwanitkit [1].…”

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confidence: 99%

“…Moreover, ZIKV causes a self-limited disease with fever, myalgia, arthralgia, maculopapular rash, and conjunctivitis in the majority of symptomatic adult patients. Our review article, however, focused mainly on neuroimaging findings of congenital ZIKV infection along with two autoimmune conditions that may complicate the acquired ZIKV infection [2].The outbreak of Zika virus infection in Brazil in 2015 was associated with an increase in the cases of congenital microcephaly by a factor of 20. The suspected causal relationship between prenatal ZIKV infection and microcephaly has now been confirmed [3].…”

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Neuroimaging findings of Zika virus infection: emphasis of congenital versus acquired aspects

2016

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about 1-13% of pregnant women infected in the first trimester will have a child with microcephaly and other cerebral abnormalities [4]. These facts suggest that congenital ZIKV infection, which is vertically transmitted to the fetus from the infected mother, is much less benign than acquired infection. This issue has made congenital ZIKV infection a "Public Health Emergency of International Concern" (World Health Organization declaration, 1 February 2016).We agree with Prof. Wiwanitkit that neuroimaging findings are most likely normal in the majority of patients with acquired Zika infection. There are a few exceptions, including adult patients complicated by ZIKV-related Guillain-Barré syndrome (GBS), which may be associated with post-contrast enhancement of the cranial nerves, conus medullaris, cauda equina nerve roots, and lumbar spinal ganglia on magnetic resonance imaging (MRI) as well as adult patients with ZIKV-related acute disseminated encephalomyelitis (ADEM) exerting brain and spinal cord changes on MRI study. On the other hand, the majority of fetuses/neonates with congenital Zika infection have abnormal neuroimaging findings including microcephaly, intracranial calcifications, malformations of cortical development (mostly polymicrogyria), cerebellar and brainstem hypoplasia, ventriculomegaly, agenesis/ hypoplasia of the corpus callosum, absent cavum septum pellucidum, white matter changes most likely due to dysmyelination, and ocular abnormalities. These findings may be detected in the prenatal or neonatal imaging studies [2,3,5].In conclusion, when discussing neuroimaging findings in Zika virus infection, it is extremely important to differentiate between congenital and acquired infection. Our review article focused mainly on congenital ZIKV infection, which is associated with abnormal neuroimaging findings Dear Editor, We appreciate the interest on our article by Prof. Viroj Wiwanitkit [1]. We agree with Dr. Wiwanitkit that acquired Zika virus (ZIKV) infection is asymptomatic in up to 80% of the affected people, and it is estimated that only 20% of infected cases are symptomatic. Moreover, ZIKV causes a self-limited disease with fever, myalgia, arthralgia, maculopapular rash, and conjunctivitis in the majority of symptomatic adult patients. Our review article, however, focused mainly on neuroimaging findings of congenital ZIKV infection along with two autoimmune conditions that may complicate the acquired ZIKV infection [2].The outbreak of Zika virus infection in Brazil in 2015 was associated with an increase in the cases of congenital microcephaly by a factor of 20. The suspected causal relationship between prenatal ZIKV infection and microcephaly has now been confirmed [3]. It is estimated that This reply refers to the article available at

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Neuroimaging findings of Zika virus infection: emphasis of congenital versus acquired aspects

2016

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“…Dear editor, On February 2016, the World Health Organization expressed that the spread of Zika virus becomes a public health emergency of International concern 1 . Zika virus is a virus of the genus flavivirus.…”

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Letter to editor: Humidity is an ambient parameter to development of Zika virus: an Indonesian case

Tosepu

2017

Afr H. Sci.

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Screening Criteria for Ophthalmic Manifestations of Congenital Zika Virus Infection

et al. 2017

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IMPORTANCECurrent guidelines recommend screening eye examinations for infants with microcephaly or laboratory-confirmed Zika virus infection but not for all infants potentially exposed to Zika virus in utero.OBJECTIVE To evaluate eye findings in a cohort of infants whose mothers had polymerase chain reaction-confirmed Zika virus infection during pregnancy.DESIGN, SETTING, AND PARTICIPANTS In this descriptive case series performed from January 2 through October 30, 2016, infants were examined from birth to 1 year of age by a multidisciplinary medical team, including a pediatric ophthalmologist, from Fernandes Figueira Institute, a Ministry of Health referral center for high-risk pregnancies and infectious diseases in children in Rio de Janeiro, Brazil.PARTICIPANTS Mother-infant pairs from Rio de Janeiro, Brazil, who presented with suspected Zika virus infection during pregnancy were referred to our institution and had serum, urine, amniotic fluid, or placenta samples tested by real-time polymerase chain reaction for Zika virus.MAIN OUTCOMES AND MEASURES Description of eye findings, presence of microcephaly or other central nervous system abnormalities, and timing of infection in infants with confirmed Zika virus during pregnancy. Eye abnormalities were correlated with central nervous system findings, microcephaly, and the timing of maternal infection. RESULTSOf the 112 with polymerase chain reaction-confirmed Zika virus infection in maternal specimens, 24 infants (21.4%) examined had eye abnormalities (median age at first eye examination, 31 days; range, 0-305 days). Ten infants (41.7%) with eye abnormalities did not have microcephaly, and 8 (33.3%) did not have any central nervous system findings. Fourteen infants with eye abnormalities (58.3%) were born to women infected in the first trimester, 8 (33.3%) in the second trimester, and 2 (8.3%) in the third trimester. Optic nerve and retinal abnormalities were the most frequent findings. Eye abnormalities were statistically associated with microcephaly (odds ratio [OR], 19.1; 95% CI, 6.0-61.0), other central nervous system abnormalities (OR, 4.

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Neuroimaging findings of Zika virus infection: a review article

Cited by 332 publications

References 37 publications

Neuroimaging findings of Zika virus infection: emphasis of congenital versus acquired aspects

Neuroimaging findings of Zika virus infection: emphasis of congenital versus acquired aspects

Letter to editor: Humidity is an ambient parameter to development of Zika virus: an Indonesian case

Screening Criteria for Ophthalmic Manifestations of Congenital Zika Virus Infection

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