Zika Virus Associated with Microcephaly
Summary
A widespread epidemic of Zika virus (ZIKV) infection was reported in 2015 in
South and Central America and the Caribbean. A major concern associated with
this infection is the apparent increased incidence of microcephaly in fetuses born
to mothers infected with ZIKV. In this report, we describe the case of an expectantmother who had a febrile illness with rash at the end of the first trimester of
pregnancy while she was living in Brazil. Ultrasonography performed at 29 weeks
of gestation revealed microcephaly with calcifications in the fetal brain and placenta.
After the mother requested termination of the pregnancy, a fetal autopsy
was performed. Micrencephaly (an abnormally small brain) was observed, with
almost complete agyria, hydrocephalus, and multifocal dystrophic calcifications in
the cortex and subcortical white matter, with associated cortical displacement and
mild focal inflammation. ZIKV was found in the fetal brain tissue on reversetranscriptase–
polymerase-chain-reaction (RT-PCR) assay, with consistent findings
on electron microscopy. The complete genome of ZIKV was recovered from the
fetal brain.