Roma José Henrique Francisco, Alves Rachel Cruz, Silva Vanessa Siano da, Ferreira Marcio José, Araújo Claudinéia de, Pavoni Juliana Helena Chavéz
Curso de Graduação em Medicina, Instituto de Ciências Exatas e Naturais, Universidade Federal de Mato Grosso, Rondonópolis, MT, Brasil.
Programa de Pós-graduação em Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brasil.
Rev Soc Bras Med Trop. 2019 Jul 18;52:e20190105. doi: 10.1590/0037-8682-0105-2019.
Clinical and epidemiological data on suspected congenital Zika syndrome (CZS) cases from southern Mato Grosso (MT) in Brazil during the Zika virus (ZIKV) outbreak in 2015-2016 were evaluated.
This is a descriptive case series study of newborns whose mothers were suspected cases of ZIKV infections during their pregnancies. The medical records of all the suspected CZS cases (mothers and newborns) treated by the specialized ambulatory service from June 2015 to August 2016 were analyzed.
Twenty suspected CZS cases were included in these analyses. They were categorized into four groups based on the clinical and laboratory findings: confirmed cases (n=1), highly probable cases (n=13), moderately probable cases (n=5), and somewhat probable cases (n=1). The mothers tested negative for STORCH (syphilis, toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex) and other important congenital infections; however, specific ZIKV tests were not performed during the study period. Microcephaly was observed in the majority of these newborns, and all the patients showed altered cranial computed tomography image findings. Extracranial abnormalities such as arthrogryposis, and otological and ophthalmological manifestations were also observed.
Although ZIKV was not confirmed to cause the congenital malformations, this study demonstrated that the clinical and epidemiological findings associated with a STORCH exclusion strengthened the CZS diagnosis. The suspected cases in MT occurred simultaneously with the first CZS cases reported in Brazil, suggesting ZIKV circulation in the study region during the same period.
对2015 - 2016年寨卡病毒(ZIKV)疫情期间巴西马托格罗索州南部疑似先天性寨卡综合征(CZS)病例的临床和流行病学数据进行了评估。
这是一项对母亲在孕期被怀疑感染ZIKV的新生儿的描述性病例系列研究。分析了2015年6月至2016年8月由专门门诊服务治疗的所有疑似CZS病例(母亲和新生儿)的病历。
这些分析纳入了20例疑似CZS病例。根据临床和实验室检查结果将它们分为四组:确诊病例(n = 1)、极可能病例(n = 13)、中度可能病例(n = 5)和有点可能病例(n = 1)。母亲的TORCH(梅毒、弓形虫病、其他感染、风疹、巨细胞病毒感染和单纯疱疹)及其他重要先天性感染检测均为阴性;然而,在研究期间未进行特定的ZIKV检测。这些新生儿中的大多数都观察到小头畸形,并且所有患者的头颅计算机断层扫描图像结果均有改变。还观察到诸如关节挛缩、耳科和眼科表现等颅外异常。
尽管未确认ZIKV会导致先天性畸形,但本研究表明,与TORCH排除相关的临床和流行病学发现加强了CZS的诊断。马托格罗索州的疑似病例与巴西报告的首批CZS病例同时出现,表明同期研究区域内存在ZIKV传播。