Is There More to Zika? Complex Cardiac Disease in a Case of Congenital Zika Syndrome

Neonatology. 2018;113(2):177-182. doi: 10.1159/000484656. Epub 2017 Dec 16.

Abstract

The epidemic of Zika virus (ZIKV) has resulted in a surge of newborns with microcephaly and brain abnormalities. In this report, we describe the first case, to our knowledge, of congenital Zika syndrome with concomitant critical congenital heart disease. The mother had a confirmed ZIKV infection in the first trimester of pregnancy. Fetal ultrasonography at 31 weeks of gestation revealed cerebral cortical calcifications and hypoplastic left heart syndrome. The severity of brain involvement was assessed by postnatal magnetic resonance imaging and echocardiogram, and palliative surgery was performed. The ethical dimensions of this infant's clinical management are discussed. ZIKV is known to affect neural progenitor cells, but whether it could have a tropism for other tissues remains unclear.

Keywords: Hypoplastic left heart syndrome; Microcephaly; Polymicrogyria; Staged palliation; Tropism.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain / diagnostic imaging
  • Brain / pathology*
  • Female
  • Heart Diseases / etiology
  • Hospice Care
  • Humans
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Male
  • Microcephaly / diagnostic imaging
  • Microcephaly / etiology
  • Microcephaly / virology*
  • Nervous System Malformations / diagnostic imaging
  • Nervous System Malformations / virology*
  • Pregnancy
  • Pregnancy Complications, Infectious / virology*
  • Ultrasonography, Prenatal
  • Zika Virus / pathogenicity
  • Zika Virus Infection / complications*
  • Zika Virus Infection / congenital