ZIKA vasculitis: A new cause of stroke in children?

J Neurol Sci. 2017 Dec 15:383:211-213. doi: 10.1016/j.jns.2017.10.045. Epub 2017 Oct 27.

Abstract

Viral infectious vasculitis is a cause of stroke in children. Zika virus infection is often asymptomatic. Neurological complications have however been reported: Guillain-Barré, ADEM, meningoencephalitis, myelitis, microcephaly in the fetus of infected mothers. We discuss the case of a child presenting acute infection with ZIKV that was associated with a stroke. A 10-months-old boy without medical history presented after 2days of fever and cutaneous rash, conjunctivitis on day 5, a right hemiparesis on day 6. Brain MRI found an ischemic stroke in the left superficial MCA territory with distal occlusion of left M1 portion of the MCA. Specific real-time reverse PCR detected Zika virus in serum. There are no known cases of cerebral infarction associated with Zika infection. However, cases of cerebral infarcts associated with dengue vasculitis have rarely been described. It has been recently showed that there is a tropism of the Zika virus for endothelial cells. This could be responsible for stroke, possibly particularly in young children.

Keywords: Child; Ischemic stroke; Vasculitis; Zika virus infection.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Brain / diagnostic imaging
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / etiology*
  • Brain Ischemia / therapy
  • Diagnosis, Differential
  • Humans
  • Infant
  • Male
  • Stroke / diagnostic imaging
  • Stroke / etiology*
  • Stroke / therapy
  • Vasculitis / complications*
  • Vasculitis / diagnostic imaging
  • Vasculitis / therapy
  • Zika Virus Infection / complications*
  • Zika Virus Infection / diagnostic imaging
  • Zika Virus Infection / therapy