Journal: PLoS Neglected Tropical Diseases
Article Title: The spectrum of neurological disease associated with Zika and chikungunya viruses in adults in Rio de Janeiro, Brazil: A case series
Figure Lengend Snippet: Central nervous system (CNS) imaging abnormalities in patients with evidence of Zika, chikungunya and/or dengue virus infection. A: Encephalomyelitis in a patient with CNS Zika and systemic dengue infection (patient 3). Fluid attenuation inversion recovery [FLAIR] signal abnormality involving the middle cerebellar peduncles, more marked on the right (axial scan). B: Acute disseminated encephalomyelitis in a patient with systemic chikungunya infection (patient 20). Confluent areas of T2 signal abnormality suggesting neuroinflammation consistent with demyelination (coronal scan). C, D, E: Encephalomyelitis with subclinical meningitis in a patient with CNS Zika + chikungunya infection (patient 9). FLAIR signal abnormality involving the medial temporal lobes, amygdala, and a small area of abnormality adjacent to the temporal horn of the left lateral ventricle (C, axial scan). High signal intensity on T2-weighted images in the anterior medulla, and anterior cervical and thoracic cord (D and E, sagittal scans). F, G, H: Myelitis in a patient with CNS Zika + dengue and systemic chikungunya infection (patient 2). Extensive intramedullary signal abnormality of the cervical cord, without evidence of contrast enhancement (F, sagittal T2-weighted scan; G, sagittal T1-weighted scan with gadolinium; H, axial T2-weighted scan). I, J: Facial diplegia with paraesthesia in patient with CNS Zika + chikungunya infection (patient 4). Bilateral facial nerve enhancement on T2-weighted images with gadolinium (axial scan).
Article Snippet: [ ] Serum IgM and IgG antibodies to Zika virus NS1 antigen and serum and CSF IgM and IgG antibodies to chikungunya virus were measured using commercial ELISAs (Euroimmun, Luebeck, Germany), according to the manufacturer’s protocol.
Techniques: Imaging, Infection