Zika Virus Infection with Prolonged Maternal Viremia and Fetal Brain Abnormalities

被引:620
|
作者
Driggers, R. W. [1 ,3 ]
Ho, C. -Y. [4 ,5 ,9 ]
Korhonen, E. M. [15 ,16 ]
Kuivanen, S. [15 ]
Jaaskelainen, A. J. [17 ,18 ]
Smura, T. [15 ]
Rosenberg, A. [4 ,5 ]
Hill, D. A. [4 ,5 ,9 ]
DeBiasi, R. L. [6 ,10 ]
Vezina, G. [7 ,11 ]
Timofeev, J. [1 ,3 ]
Rodriguez, F. J. [2 ]
Levanov, L. [15 ]
Razak, J. [3 ]
Iyengar, P. [12 ]
Hennenfent, A. [13 ]
Kennedy, R. [14 ]
Lanciotti, R. [19 ]
du Plessis, A. [8 ]
Vapalahti, O. [15 ,16 ,17 ,18 ]
机构
[1] Johns Hopkins Univ, Sch Med, Dept Gynecol & Obstet, Div Maternal Fetal Med, Baltimore, MD 21205 USA
[2] Johns Hopkins Univ, Sch Med, Dept Pathol, Baltimore, MD 21205 USA
[3] Childrens Natl Hlth Syst, Sibley Mem Hosp, Div Maternal Fetal Med, Washington, DC 20010 USA
[4] Childrens Natl Hlth Syst, Div Pathol, Washington, DC USA
[5] Childrens Natl Hlth Syst, Med Genet Res Ctr, Washington, DC USA
[6] Childrens Natl Hlth Syst, Div Pediat Infect Dis, Washington, DC USA
[7] Childrens Natl Hlth Syst, Dept Diagnost Radiol & Imaging, Washington, DC USA
[8] Childrens Natl Hlth Syst, Div Fetal & Transit Med, Fetal Med Inst, Washington, DC 20010 USA
[9] George Washington Univ, Sch Med & Hlth Sci, Dept Integrat Syst Biol, Washington, DC 20052 USA
[10] George Washington Univ, Sch Med & Hlth Sci, Dept Pediat & Microbiol Immunol & Trop Med, Washington, DC 20052 USA
[11] George Washington Univ, Sch Med & Hlth Sci, Dept Radiol & Pediat, Washington, DC 20052 USA
[12] Ctr Dis Control & Prevent CDC, Ctr Policy Planning & Evaluat, Washington, DC USA
[13] Dist Columbia Dept Hlth, Council State & Territorial Epidemiologists CST A, Washington, DC USA
[14] One Med Grp, Washington, DC USA
[15] Univ Helsinki, Dept Virol, Helsinki, Finland
[16] Univ Helsinki, Dept Vet Biosci, Helsinki, Finland
[17] Univ Helsinki, Dept Virol & Immunol, Helsinki, Finland
[18] Helsinki Univ Hosp, Helsinki, Finland
[19] CDC, Arboviral Dis Branch, Div Vector Borne Dis, Natl Ctr Emerging Zoonot Infect Dis, Atlanta, GA 30333 USA
来源
NEW ENGLAND JOURNAL OF MEDICINE | 2016年 / 374卷 / 22期
关键词
TRANSMISSION;
D O I
10.1056/NEJMoa1601824
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The current outbreak of Zika virus (ZIKV) infection has been associated with an apparent increased risk of congenital microcephaly. We describe a case of a pregnant woman and her fetus infected with ZIKV during the 11th gestational week. The fetal head circumference decreased from the 47th percentile to the 24th percentile between 16 and 20 weeks of gestation. ZIKV RNA was identified in maternal serum at 16 and 21 weeks of gestation. At 19 and 20 weeks of gestation, substantial brain abnormalities were detected on ultrasonography and magnetic resonance imaging (MRI) without the presence of microcephaly or intracranial calcifications. On postmortem analysis of the fetal brain, diffuse cerebral cortical thinning, high ZIKV RNA loads, and viral particles were detected, and ZIKV was subsequently isolated.
引用
收藏
页码:2142 / 2151
页数:10
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