We report a case of a Brazilian child born in 2011 with congenital Zika syndrome phenotype. Zika virus (ZIKV) may have been circulating in Brazil more than 4 years before the outbreak. ZIKV infection might be considered in children with this phenotype even without known circulation of ZIKV.
Keywords: Zika virus; congenital Zika syndrome; dengue; fetal brain disruption sequence; isochromosome X; microcephaly.