Possible Congenital Zika Syndrome in Older Children Due to Earlier Circulation of Zika Virus
Possible Congenital Zika Syndrome in Older Children Due to Earlier Circulation of Zika Virus
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DOI：
10.1002/ajmg.a.40378
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发表时间：
2018-09-01
影响因子：
2
通讯作者：
Rasmussen, Sonja A.
中科院分区：
文献类型：
--
作者：
Chu, Victoria;Petersen, Lyle R.;Rasmussen, Sonja A.
寨卡病毒（ZIKV）是寨卡病毒病的一种常见类型。两名儿童的临床表现与CZS，年龄7和8岁，一致的描述。两名母亲在怀孕期间都住在柬埔寨，这是一个已知的ZIKV地区，并在怀孕中期报告发烧和皮疹。这些婴儿出生时患有严重的小头畸形。出生时的先天性感染检测和基因检测并不明显。2017年，两名母亲的血清学检测与既往ZIKV感染一致。婴儿神经影像学检查显示脑室扩大、重度脑萎缩和皮质下钙化，与CZS一致。考虑到母亲在怀孕期间的症状表明ZIKV感染以及CZS独特的临床和放射学特征的组合，强烈怀疑这些儿童中存在CZS，这表明CZS发生在2013-2014年法属波利尼西亚爆发之前。因此，在患有病因不明的先天性小头畸形和与可能的ZIKV暴露一致的病史的较大儿童中应考虑CZS。
Congenital Zika syndrome (CZS) was identified following a large Zika virus (ZIKV) outbreak in Brazil in 2015. Two children with clinical presentations consistent with CZS, ages 7 and 8 years old, are described. Both mothers lived in Cambodia, a region with known ZIKV, during their pregnancies and reported fever and rash in the second trimester. The infants were born with severe microcephaly. Testing for congenital infection at birth and genetic testing were unremarkable. In 2017, serologic testing for both mothers were consistent with prior ZIKV infection. Review of infant neuroimaging demonstrated ventriculomegaly, severe cerebral atrophy, and subcortical calcifications consistent with CZS. Given the maternal symptoms suggesting ZIKV infection during pregnancy and the combination of clinical and radiological features unique to CZS, CZS is strongly suspected in these children, suggesting that CZS occurred before the 2013-2014 French Polynesia outbreak. As such, CZS should be considered in older children with congenital microcephaly of unknown etiology and a history consistent with possible ZIKV exposure.