Neurology Department, University Hospital of Pointe-à-Pitre, Guadeloupe, France.
Paediatrics Department, University Hospital of Pointe-à-Pitre, Guadeloupe, France.
J Neurol Sci. 2017 Dec 15;383:211-213. doi: 10.1016/j.jns.2017.10.045. Epub 2017 Oct 27.
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.
病毒性传染性血管炎是儿童中风的一个病因。 Zika 病毒感染通常是无症状的。然而，已经有报道称其存在神经并发症：Guillain-Barré、ADEM、脑膜脑炎、脊髓炎、感染母亲胎儿的小头畸形。我们讨论了一例伴有中风的急性 Zika 病毒感染患儿。一名 10 月龄、无既往病史的男婴在发热和皮疹 2 天后出现，第 5 天出现结膜炎，第 6 天出现右侧偏瘫。脑 MRI 发现左侧大脑中动脉浅支区域的缺血性中风，左侧大脑中动脉 M1 段的远端闭塞。特异性实时逆转录 PCR 在血清中检测到 Zika 病毒。没有已知与 Zika 感染相关的脑梗死病例。然而，与登革热血管炎相关的脑梗死病例很少被描述。最近有研究表明，Zika 病毒对血管内皮细胞有嗜性。这可能导致中风，尤其是在年幼的儿童中。
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