Zika Virus, Chikungunya Virus, and Dengue Virus in Cerebrospinal Fluid from Adults with Neurological Manifestations, Guayaquil, Ecuador.
Zika virus (ZIKV), chikungunya virus (CHIKV), and dengue virus (DENV) have been associated with clinical presentations that involve acute neurological complaints. In the current study, we identified ZIKV, CHIKV, and DENV in cerebrospinal fluid (CSF) samples from patients admitted to the Hospital Luis Vernaza (Guayaquil, Ecuador) to the Emergency Room or the Intensive Care Unit, with neurological symptoms and/or concern for acute arboviral infections. Viral RNA from one or more virus was detected in 12/16 patients. Six patients were diagnosed with meningitis or encephalitis, three with Guillain-Barré Syndrome, and one with CNS vasculitis. Two additional patients had a systemic febrile illness including headache that prompted testing of CSF. Two patients, who were diagnosed with encephalitis and meningoencephalitis, died during their hospitalizations. These cases demonstrate the breadth and significance of neurological manifestations associated with ZIKV, CHIKV, and DENV infections.
Laboratorio de Biología Molecular, Hospital Luis Vernaza Guayaquil, Ecuador.
Nathalie
N
Acevedo
Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta GA, USA.
Jesse
J
Waggoner
Departamento de Medicina Interna, Hospital Luis Vernaza Guayaquil, Ecuador.
Michelle
M
Rodriguez
Laboratorio de Biología Molecular, Hospital Luis Vernaza Guayaquil, Ecuador.
Lissette
L
Rivera
Laboratorio de Biología Molecular, Hospital Luis Vernaza Guayaquil, Ecuador.
José
J
Landivar
Department of Pathology, Stanford University School of Medicine, StanfordCA, USA; Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, StanfordCA, USA.
Benjamin
B
Pinsky
Laboratorio de Biología Molecular, Hospital Luis Vernaza Guayaquil, Ecuador.
Hector
H
Zambrano
Guillain–Barre syndrome; Zika virus; cerebrospinal fluid; chikungunya virus; dengue virus; meningitis; molecular diagnosis