Microcephaly Associated with Congenital Zika Infection

First Confirmed Case in Tolima

  • Sandra Patricia Mansilla Rosas Universidad del Tolima
  • John Edgar Varón Pérez Universidad del Tolima

Abstract

The Zika virus was responsible in Colombia for the second largest epidemic on the continent after Brazil during the 2015-2017 period. With 100,000 reported cases, 19,963 infected pregnant women and 248 cases of children born with microcephaly, the epidemic was declared to have ended in the country in 2016. It is the cause of the Congenital Zika Syndrome (CZS), suspected for the first time in Rio de Janeiro where the relationship between Zika infection in pregnant women and the increase in the incidence of microcephaly was established. Subsequently, a whole series of congenital disorders in the fetus would be considered at the neurological, sensory, and musculoskeletal levels, thus confirming the teratogenic effect of the virus. The case of a four-month and twenty-day old patient coming from the rural area of Ibagué and attending the kangaroo mother program of the Maternal and Child Unit of Tolima (UMIT) is presented. The child was diagnosed with microcephaly associated with congenital Zika neuroinfection confirmed by RT-PCR test to the mother by the National Institute of Health. It presents imaging, physical, and clinical findings such as a head circumference persistently below -3SD, tone disorder, and a severe Psychomotor Development Retardation (PDR) with a persistent neurological age of three months in all controls. Cortical atrophy, periventricular and basal ganglia micro-calcification, and ventriculomegaly. This is the first of twenty-one patients with clinical suspicion and confirmation with findings similar to those presented in the literature. The importance of detecting these cases lies in the neurological risk presented by motor, cognitive and sensory involvement and also in the differentiation with TORCH neurological sequelae and chromosomal abnormalities.

Author Biographies

Sandra Patricia Mansilla Rosas, Universidad del Tolima

MD, Pediatra, Neuróloga Infantil. Docente Departamento de Ciencias Clínicas, Programa de Medicina, Universidad del Tolima, Ibagué, Colombia.

John Edgar Varón Pérez, Universidad del Tolima

MD, Departamento de Ciencias Clínicas, Programa de Medicina. Universidad del Tolima, Ibagué, Tolima.

Downloads

Download data is not yet available.

Author Biographies

Sandra Patricia Mansilla Rosas, Universidad del Tolima

MD, Pediatra, Neuróloga Infantil. Docente Departamento de Ciencias Clínicas, Programa de Medicina, Universidad del Tolima, Ibagué, Colombia.

John Edgar Varón Pérez, Universidad del Tolima

MD, Departamento de Ciencias Clínicas, Programa de Medicina. Universidad del Tolima, Ibagué, Tolima.

References

Dick GWA. Zika virus (II). Pathogenicity and physical properties [Internet]. Trans R Soc Trop Med Hyg. 1952;46(5):521-534. doi: https://doi.org/10.1016/0035-9203(52)90043-6

Duffy MR, Chen T-H, Hancock WT, Powers AM, Kool JL, Lanciotti RS, et al. Zika Virus Outbreak on Yap Island, Federated States of Micronesia [Internet]. N Engl J Med. 2009;360(24):2536-2543. doi: https://doi.org/10.1056/NEJMoa0805715

Petersen LR, Jamieson DJ, Powers AM, Honein MA. Zika Virus [Internet]. Baden LR, editor. N Engl J Med. 2016;374(16):1552-1563. doi: https://doi.org/10.1056/NEJMra1602113

Sherley M, Ong CW. Sexual transmission of Zika virus: a literature review [Internet]. Sex Health. 2018;15(3):183-199. doi: https://doi.org/10.1071/SH17046

Hills SL. Transmission of Zika Virus Through Sexual Contact with Travelers to Areas of Ongoing Transmission — Continental United States, 2016. [Internet]. mmwr Morb Mortal Wkly Rep. 2016;65(8):215-216. doi: https://doi.org/10.15585/mmwr.mm6508e2er

Deckard DT. Male-to-Male Sexual Transmission of Zika Virus[Internet]. mmwr Morb Mortal Wkly Rep. 2016;65(14):372-374. doi: https://doi.org/10.15585/mmwr.mm6514a3

Laval F de, Matheus S, Labrousse T, Enfissi A, Rousset D, Briolant S. Kinetics of Zika Viral Load in Semen [Internet]. N Engl J Med. 2017;377:697-699. doi: https://doi.org/10.1056/NEJMc1612600

Méndez N, Oviedo-Pastrana M, Mattar S, Caicedo-Castro I, Arrieta G. Zika virus disease, microcephaly and Guillain-Barré syndrome in Colombia: epidemiological situation during 21 months of the Zika virus outbreak, 2015-2017 [Internet]. Arch Public Health. 2017;75:65. doi: https://doi.org/10.1186/s13690-017-0233-5

Pan American Health Organization / World Health Organization. Zika suspected and confirmed cases reported by countries and territories in the Americas Cumulative cases, 2015-2017 [Internet]. 2018. Disponible en: https://www.paho.org/hq/dmdocuments/2017/2017-ago-10-phe-ZIKV-casess.pdf

MinSaludCol. Minsalud declara el cierre de la epidemia de zika en Colombia (Rueda de Prensa) [Internet]. 2018. Disponible en: https://www.youtube.com/watch?v=cAQZ-2j1CdM&feature=youtu.be

Instituto Nacional de Salud. Informe De Evento. Enfermedad Por Virus Zika, Colombia 2017 [Internet]. Disponible en: https://www.ins.gov.co/buscador-eventos/Informesdeevento/ZIKA%202017.pdf

Brasil P, Pereira JP, Moreira ME, Ribeiro Nogueira RM, Damasceno L, Wakimoto M, et al. Zika Virus Infection in Pregnant Women in Rio de Janeiro [Internet]. N Engl J Med. 2016;375(24):2321-2334. doi: https://doi.org/10.1056/NEJMoa1602412

Adebanjo T, Godfred-Cato S, Viens L, Fischer M, Staples JE, Kuhnert-Tallman W, et al. Update: Interim Guidance for the Diagnosis, Evaluation, and Management of Infants with Possible Congenital Zika Virus Infection - United States, October 2017 [Internet]. mmwr Morb Mortal Wkly Rep. 2017;66(41):1089-1099. doi: https://doi.org/10.15585/mmwr.mm6641a1

Parra-Saavedra M, Reefhuis J, Piraquive JP, Gilboa SM, Badell ML, Moore CA, et al. Serial Head and Brain Imaging of 17 Fetuses With Confirmed Zika Virus Infection in Colombia, South America [Internet]. Obstet Gynecol. 2017;130(1):207-212. doi: https://doi.org/10.1097/AOG.0000000000002105

Chimelli L, Melo ASO, Avvad-Portari E, Wiley CA, Camacho AHS, Lopes VS, et al. The spectrum of neuropathological changes associated with congenital Zika virus infection [Internet]. Acta Neuropathol (Berl). 2017;133(6):983-999. doi: https://doi.org/10.1007/s00401-017-1699-5

Coffey LL, Keesler RI, Pesavento PA, Woolard K, Singapuri A, Watanabe J, et al. Intraamniotic Zika virus inoculation of pregnant rhesus macaques produces fetal neurologic disease [Internet]. Nat Commun. 2018;9(1):2414. doi: https://doi.org/10.1038/s41467-018-04777-6

Costa Monteiro LM, Cruz GN de O, Fontes JM, Saad Salles TRD, Boechat MCB, Monteiro AC, et al. Neurogenic bladder findings in patients with Congenital Zika Syndrome: A novel condition [Internet]. PloS One. 2018;13(3):e0193514. doi: https://doi.org/10.1371/journal.pone.0193514

Solomon IH, Milner DA. Neuropathology of Zika Virus Infection [Internet]. J Neuroinfectious Dis. 2016;7(2):220. doi: https://doi.org/10.4172/2314-7326.1000220

Gharbaran R, Somenarain L. Insights into the molecular roles of Zika virus in human reproductive complications and congenital neuropathologies [Internet]. Pathology (Phila). 2017;49(7):707-714. doi: https://doi.org/10.1016/j.pathol.2017.07.008

Kim K, Shresta S. Neuroteratogenic Viruses and Lessons for Zika Virus Models [Internet]. Trends Microbiol. 2016;24(8):622-636. doi: https://doi.org/10.1016/j.tim.2016.06.002

Moore CA, Staples JE, Dobyns WB, Pessoa A, Ventura CV, Fonseca EB da, et al. Characterizing the Pattern of Anomalies in Congenital Zika Syndrome for Pediatric Clinicians [Internet]. jama Pediatr. 2017;171(3):288-295. doi: https://doi.org/10.1001/jamapediatrics.2016.3982

Alvarado MG, Schwartz DA. Zika Virus Infection in Pregnancy, Microcephaly, and Maternal and Fetal Health: What We Think, What We Know, and What We Think We Know [Internet]. Arch Pathol Lab Med. 2017;141(1):26-32. doi: https://doi.org/10.5858/arpa.2016-0382-RA

Araújo TVB de, Rodrigues LC, de Alencar Ximenes RA, de Barros Miranda-Filho D, Montarroyos UR, de Melo APL, et al. Association between Zika virus infection and microcephaly in Brazil, January to May, 2016: preliminary report of a case-control study [Internet]. Lancet Infect Dis. 2016;16(12):1356-1363. doi: https://doi.org/10.1016/S1473-3099(16)30318-8

França GVA, Schuler-Faccini L, Oliveira WK, Henriques CMP, Carmo EH, Pedi VD, et al. Congenital Zika virus syndrome in Brazil: a case series of the first 1501 livebirths with complete investigation [Internet]. Lancet Lond Engl. 2016;388(10047):891-897. doi: https://doi.org/10.1016/S0140-6736(16)30902-3

Driggers RW, Ho C-Y, Korhonen EM, Kuivanen S, Jääskeläinen AJ, Smura T, et al. Zika Virus Infection with Prolonged Maternal Viremia and Fetal Brain Abnormalities [Internet]. N Engl J Med. 2016;374(22):2142-2151. doi: https://doi.org/10.1056/NEJMoa1601824

Carvalho MDCG, Miranda-Filho D de B, van der Linden V, Sobral PF, Ramos RCF, Rocha MÂW, et al. Sleep eeg patterns in infants with congenital Zika virus síndrome [Internet]. Clin Neurophysiol Off J Int Fed Clin Neurophysiol. 2017;128(1):204-214. doi: https://doi.org/10.1016/j.clinph.2016.11.004

Aleman TS, Ventura CV, Cavalcanti MM, Serrano LW, Traband A, Nti AA, et al. Quantitative Assessment of Microstructural Changes of the Retina in Infants With Congenital Zika Syndrome [Internet]. jama Ophthalmol. 2017;135(10):1069-1076. doi: https://doi.org/10.1001/jamaophthalmol.2017.3292

Fernandez MP, Parra Saad E, Ospina Martínez M, Corchuelo S, Mercado Reyes M, Herrera MJ, et al. Ocular Histopathologic Features of Congenital Zika Syndrome [Internet]. jama Ophthalmol. 2017;135(11):1163-1639. doi: https://doi.org/10.1001/jamaophthalmol.2017.3595

Yepez JB, Murati FA, Pettito M, Peñaranda CF, de Yepez J, Maestre G, et al. Ophthalmic Manifestations of Congenital Zika Syndrome in Colombia and Venezuela [Internet]. jama Ophthalmol. 2017;135(5):440-445. doi: https://doi.org/10.1001/jamaophthalmol.2017.0561

Rodríguez-Morales A, Patiño-Valencia S, Villamil-Gómez W, Alvarado-Socarras J, Jimenez-Canizales C. Situación del Zika en Colombia: Experiencia de miembros de la Red Colombiana de Colaboración en Zika (Recolzica) [Internet]. Acta Médica Peruana. 2016;33(1):79-81. doi: https://doi.org/10.35663/amp.2016.331.22

How to Cite
Mansilla Rosas, S. P., & Varón Pérez, J. E. (2020). Microcephaly Associated with Congenital Zika Infection: First Confirmed Case in Tolima. Revista Med, 28(1), 51–57. https://doi.org/10.18359/rmed.3691
Published
2020-09-11
Section
Reporte de caso

Altmetric

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
Scan to share
QR code to open and share this publication

Some similar items: