PT  - JOURNAL ARTICLE
AU  - Mauro Mitsuru Hanaoka
AU  - Alexandre Fligelman Kanas
AU  - Carla Torres Braconi
AU  - Érica Araújo Mendes
AU  - Robert Andreata Santos
AU  - Luís Carlos de Souza Ferreira
AU  - Marielton dos Passos Cunha
AU  - Patrícia Beltrão Braga
AU  - João Leonardo Mendonça Dias
AU  - Carolina Manganeli Polonio
AU  - David Anibal Garrido Andrade
AU  - Carla Longo de Freitas
AU  - Cristiano Rossato
AU  - Wesley Nogueira Brandão
AU  - Jean Pierre Schatzmann Peron
AU  - Antonio Gomes de Amorim Filho
AU  - Joelma Queiroz Andrade
AU  - Rossana Pulcineli Vieira Francisco
AU  - Fernando Kok
AU  - Lisa Suzuki
AU  - Claudia da Costa Leite
AU  - Leandro Tavares Lucato
AU  - Amadou Alpha Sall
AU  - Paolo Marinho de Andrade Zanotto
TI  - A Zika virus-associated microcephaly case with background exposure to STORCH agents
AID  - 10.1101/052340
DP  - 2016 Jan 01
TA  - bioRxiv
PG  - 052340
4099  - http://biorxiv.org/content/early/2016/05/10/052340.short
4100  - http://biorxiv.org/content/early/2016/05/10/052340.full
AB  - We present a case of microcephaly associated with Zika virus (ZIKV) in a chronological, multimodal imaging approach, illustrating the hallmarks of this disease on intrauterine morphological ultrasound, transfontanelar ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI). We also determined the serological e immunological status of the mother and newborn. Noticeably, there was evidence for maternal infection by ZIKV, cytomegalovirus (CMV), herpes simplex virus (HSV), dengue virus (DENV) and Toxoplasma gondii, which indicates a possible role of previous exposures to STORCH agents and possibly comorbidities in the severe fetal congenital manifestation.Author Summary Zika virus (ZIKV) is an emerging mosquito-borne arbovirus causing dengue-like symptoms. In humans the illness is characterized by malaise and cutaneous rash and absent or short-termed fever. Recently, the Brazilian Ministry of Health reported an outbreak of microcephaly in Brazil as a delayed effect of the 2014-2015 outbreak of ZIKV in the Northeast of Brazil. A 20-fold increase in the notifications of newborns with microcephaly was documented during the second semester of 2015. This increase was almost immediately found to be associated with ZIKV infections, both in Brazil and, retrospectively, in French Polynesia. Herein we report a case of microcephaly associated with ZIKV and we also present evidence of other maternal infections. Our results indicated that, both mother and microcephaly infant had immunologic status compatible with previous exposure (in the mother) by STORCH agents. These indicate a possible role of previous exposures and possibly comorbidities in the severe fetal congenital manifestation. □