title: Zika Virus Causing Encephalomyelitis Associated With Immunoactivation.
abstract: Brazil has experienced a Zika virus (ZIKV) outbreak with increased incidence of congenital malformations and neurological manifestations. We describe a case of a 26-year-old Brazilian Caucasian man infected with ZIKV and diagnosed with encephalomyelitis. Brain and spinal cord images showed hyperintense lesions on T2 and fluid-attenuated inversion recovery (FLAIR), and levels of proinflammatory cytokines in the cerebrospinal fluid showed a remarkable increase of interleukin (IL)-6 and IL-8. The observed pattern suggests immune activation during the acute phase, along with the neurological impairment, with normalization in the recovery phase. This is the first longitudinal report of ZIKV infection causing encephalomyelitis with documented immune activation.
authors.affiliation: Instituto Estadual de Infectologia São Sebastião, Rio de Janeiro, Brazil;; Programa de Pós-Graduação em Clínica Médica da Faculdade de Medicina da Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Rafael Mello
authors.initials: RM
authors.lastname: Galliez
authors.affiliation: University of the State of Rio de Janeiro, Brazil;; Neurology Service and.
authors.forename: Mariana
authors.initials: M
authors.lastname: Spitz
authors.affiliation: Epidemiology Service, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil;; D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
authors.forename: Patricia Piazza
authors.initials: PP
authors.lastname: Rafful
authors.affiliation: University of the State of Rio de Janeiro, Brazil;; Neurology Service and.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Cagy
authors.affiliation: Epidemiology Service, Hospital Federal dos Servidores do Estado , Rio de Janeiro , Brazil.
authors.forename: Claudia
authors.initials: C
authors.lastname: Escosteguy
authors.affiliation: University of the State of Rio de Janeiro, Brazil;; Neurology Service and.
authors.forename: Caroline Spósito Brito
authors.initials: CS
authors.lastname: Germano
authors.affiliation: University of the State of Rio de Janeiro, Brazil;; Neurology Service and.
authors.forename: Elisa
authors.initials: E
authors.lastname: Sasse
authors.affiliation: Genetics Department, Biology Institute , and.
authors.forename: Alessandro Luis
authors.initials: AL
authors.lastname: Gonçalves
authors.affiliation: Genetics Department, Biology Institute , and.
authors.forename: Paola Paz
authors.initials: PP
authors.lastname: Silveira
authors.affiliation: Genetics Department, Biology Institute , and.
authors.forename: Paula
authors.initials: P
authors.lastname: Pezzuto
authors.affiliation: Genetics Department, Biology Institute , and.
authors.forename: Alice Maria de Magalhães
authors.initials: AM
authors.lastname: Ornelas
authors.affiliation: Genetics Department, Biology Institute , and.
authors.forename: Amilcar
authors.initials: A
authors.lastname: Tanuri
authors.affiliation: Genetics Department, Biology Institute , and.
authors.forename: Renato Santana
authors.initials: RS
authors.lastname: Aguiar
authors.affiliation: Epidemiology Service, Hospital Federal dos Servidores do Estado, Rio de Janeiro, Brazil;; Radiology Department, and.
authors.forename: Fernanda Tovar
authors.initials: FT
authors.lastname: Moll
keywords: Zika virus.; encephalomyelitis; neurological manifestations; proinflammatory cytokines