Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Medline ® Abstract for Reference 134

of 'Zika virus infection: An overview'

Zika Virus Meningoencephalitis in an Immunocompromised Patient.
Schwartzmann PV, Ramalho LN, Neder L, Vilar FC, Ayub-Ferreira SM, Romeiro MF, Takayanagui OM, Dos Santos AC, Schmidt A, Figueiredo LT, Arena R, Simões MV
Mayo Clin Proc. 2017 Mar;92(3):460-466.
The World Health Organization considers the Zika virus (ZIKV) outbreak in the Americas a global public health emergency. The neurologic complications due to ZIKV infection comprise microcephaly, meningoencephalitis, and Guillain-Barrésyndrome. We describe a fatal case of an adult patient receiving an immunosuppressive regimen following heart transplant. The patient was admitted with acute neurologic impairment and experienced progressive hemodynamic instability and mental deterioration that finally culminated in death. At autopsy, a pseudotumoral form of ZIKV meningoencephalitis was confirmed. Zika virus infection was documented by reverse trancriptase-polymerase chain reaction, immunohistochemistry, and immunofluorescence and electron microscopy of the brain parenchyma and cerebral spinal fluid. The sequencing of the viral genome in this patient confirmed a Brazilian ZIKV strain. In this case, central nervous system involvement and ZIKV propagation to other organs in a disseminated pattern is quite similar to that observed in other fatal Flaviviridae viral infections.
Cardiology Centre, Internal Medicine Department, Medical School of Ribeirão Preto, University of São Paulo, Brazil. Electronic address: pedrovs@usp.br.