Congenital Zika virus syndrome…what else? Two case reports of severe combined fetal pathologies.
Details
Serval ID
serval:BIB_6C676820C29B
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Congenital Zika virus syndrome…what else? Two case reports of severe combined fetal pathologies.
Journal
BMC pregnancy and childbirth
ISSN
1471-2393 (Electronic)
ISSN-L
1471-2393
Publication state
Published
Issued date
03/09/2018
Peer-reviewed
Oui
Volume
18
Number
1
Pages
356
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: epublish
Publication Status: epublish
Abstract
Zika virus (ZIKV) has recently emerged as a teratogenic infectious agent associated with severe fetal cerebral anomalies. Other microorganisms (TORCH agents) as well as genetic disorders and toxic agents may lead to similar anomalies. In case of fetal anomalies, the exact etiology might be difficult to establish, especially in ZIKV endemic countries. As the risks associated with maternal infection remain unclear adequate parental counseling is difficult.
We present two cases of severe fetal pathologies managed in our multidisciplinary center during the ZIKV outbreak in Martinique, a French Caribbean Island. Both fetuses had congenital ZIKV infection confirmed by RT-PCR. While one case presented with significant cerebral anomalies, the other one presented with hydrops fetalis. A complete analysis revealed that the fetal lesions observed resulted from a combination of ZIKV congenital infection and a genetic disorder (trisomy 18) in case 1 or congenital Parvovirus B19 infection in case 2.
We highlight the difficulties related to adequate diagnosis in case of suspected ZIKV congenital syndrome. Additional factors may contribute to or cause fetal pathology, even in the presence of a confirmed ZIKV fetal infection. An exact diagnosis is mandatory to draw definitive conclusions. We further emphasize that, similarly to other congenital infections, it is very likely that not all infected fetuses will become symptomatic.
We present two cases of severe fetal pathologies managed in our multidisciplinary center during the ZIKV outbreak in Martinique, a French Caribbean Island. Both fetuses had congenital ZIKV infection confirmed by RT-PCR. While one case presented with significant cerebral anomalies, the other one presented with hydrops fetalis. A complete analysis revealed that the fetal lesions observed resulted from a combination of ZIKV congenital infection and a genetic disorder (trisomy 18) in case 1 or congenital Parvovirus B19 infection in case 2.
We highlight the difficulties related to adequate diagnosis in case of suspected ZIKV congenital syndrome. Additional factors may contribute to or cause fetal pathology, even in the presence of a confirmed ZIKV fetal infection. An exact diagnosis is mandatory to draw definitive conclusions. We further emphasize that, similarly to other congenital infections, it is very likely that not all infected fetuses will become symptomatic.
Keywords
Congenital Abnormalities/virology, Humans, Infant, Newborn, Parvoviridae Infections/virology, Parvovirus B19, Human, Trisomy 18 Syndrome/virology, Zika Virus, Zika Virus Infection/virology, Congenital Zika syndrome, Fetal anemia, Microcephaly, Parvovirus B19, Trisomy 18
Pubmed
Web of science
Open Access
Yes
Create date
10/09/2018 16:42
Last modification date
20/08/2019 15:26