title: Clinical and Imaging Findings in an Infant With Zika Embryopathy.
abstract: Recent Zika virus (ZIKV) outbreaks have been associated with an increased incidence of neonatal microcephaly. Subsequently, tropism for the brain was established in human fetal brain tissue. We present the first congenital ZIKV infection in the United States, confirmed by high ZIKV immunoglobulin M antibody titers in serum and cerebrospinal fluid. The phenotypic characteristics of the patient fall within fetal brain disruption sequence, suggesting impaired brain development in the second half of gestation. Brain imaging revealed an almost agyric brain with diffuse parenchymal calcifications, hydrocephalus ex vacuo, and cerebellar hypoplasia. Ophthalmologic examination revealed macular pigment stippling and optic nerve atrophy. Liver, lungs, heart, and bone marrow were not affected. The patient had progressive neurologic deterioration in the first month of life. The discovery of ZIKV infection in human fetal brain tissue along with serologic confirmation proves the vertical transmission of ZIKV. Therefore, ZIKV has joined the group of congenital infections.
authors.affiliation: Department of Pediatrics.
authors.forename: Marko
authors.initials: M
authors.lastname: Culjat
authors.affiliation: Department of Radiology, Kapi'olani Medical Center for Women and Children.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Darling
authors.affiliation: Department of Tropical Medicine, Medical Microbiology and Pharmacology, Pacific Center for Emerging Infectious Diseases Research, John A. Burns School of Medicine, University of Hawai'i at Manoa.
authors.forename: Vivek R
authors.initials: VR
authors.lastname: Nerurkar
authors.affiliation: Department of Pediatrics.
authors.forename: Natascha
authors.initials: N
authors.lastname: Ching
authors.affiliation: Department of Tropical Medicine, Medical Microbiology and Pharmacology, Pacific Center for Emerging Infectious Diseases Research, John A. Burns School of Medicine, University of Hawai'i at Manoa.
authors.forename: Mukesh
authors.initials: M
authors.lastname: Kumar
authors.affiliation: Department of Pediatrics.
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Min
authors.affiliation: Kapi'olani Medical Center for Women and Children.
authors.forename: Rupa
authors.initials: R
authors.lastname: Wong
authors.affiliation: Department of Pediatrics.
authors.forename: Leon
authors.initials: L
authors.lastname: Grant
authors.affiliation: Kapi'olani Medical Center for Women and Children Department of Pediatrics, Department of Tropical Medicine, Medical Microbiology and Pharmacology, Pacific Center for Emerging Infectious Diseases Research, John A. Burns School of Medicine, Honolulu, Hawaii.
authors.forename: Marian E
authors.initials: ME
authors.lastname: Melish
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008831:Microcephaly / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology; D010920:Placenta / Q000473:pathology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology; D016216:Ultrasonography, Prenatal; D000071243:Zika Virus Infection
keywords: MRI; Zika virus; fetal brain disruption sequence; microcephaly; ultrasound