Zika virus infection (neonatal)

Infectious diseases
Pediatric diseases

General description

Zika virus infection is a mosquito-borne disease caused by the Zika virus, belonging to the Flavivirus family. It is primarily transmitted by Aedes mosquitoes, such as Aedes aegypti and Aedes albopictus, and is prevalent in tropical and subtropical regions, including Southeast Asia, Africa, and Central and South America.

Approximately 80% of infected individuals remain asymptomatic. Among those who develop symptoms after an incubation period of 2 to 7 days, common manifestations include mild fever, joint pain, skin rashes (erythema and maculopapular rash), and conjunctival redness. Other possible symptoms include headache, muscle pain, and retro-orbital pain.

Zika virus infection poses a significant risk to pregnant women, as the virus can be transmitted to the fetus through the placenta. This can lead to congenital Zika syndrome, characterized by severe neurological complications such as microcephaly, brain atrophy, hypertonia, hyperreflexia, seizures, ocular abnormalities, and sensorineural hearing loss. The risk of severe neurological damage is highest when infection occurs before 14 weeks of gestation.

While mosquito bites are the primary mode of transmission, human-to-human transmission is rare. However, cases of transmission through sexual contact, blood transfusion, tears, and other bodily fluids have been reported.

Calcification

  • Cerebrum
    Cerebral white matter
    Subcortical white matter
  • Caudate nucleus
  • Putamen
  • Globus pallidus
  • Thalamus
  • Brainstem
  • Cerebellum
Bilateral
Multiple
Coarse
Plain CT
Calcified attenuation
Multiple
Coarse
T2*WI
Hypointensity
SWI
Hypointensity

Calcifications of the cerebral parenchyma are observed in nearly all cases of congenital Zika virus encephalitis. These calcifications typically occur in the subcortical white matter, subependymal regions, basal ganglia, thalamus, brainstem, and cerebellum.

Ventricular enlargement

  • Ventricle
    Lateral ventricle
    Posterior horn
Morphology
Enlargement / swelling

White matter lesion

  • Cerebrum
    Cerebral white matter
T2WI
Hyperintensity
Water intensity
FLAIR
Hyperintensity
Water intensity

Cerebral malformation

  • Cerebrum
Morphology
Microcephaly
Lissencephaly
Polymicrogyria

Congenital Zika virus infection is associated with various brain abnormalities, including microcephaly, corpus callosum malformations such as thinning, hypoplasia, or agenesis, as well as cortical gyration abnormalities like lissencephaly and polymicrogyria. Additionally, hypoplasia of the cerebellum and brainstem is observed.

Corpus callosum anomaly

  • Corpus callosum
Morphology
Aplasty
Atrophy

Cerebellum and brainstem atrophy

  • Cerebellum
  • Brainstem
Morphology
Atrophy