CC-BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2018; 40(01): 053
DOI: 10.1055/s-0037-1605375
Letter to the Editor
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Zika Virus Infection, Pregnancy and Microcephaly

Infecção por vírus Zika, gravidez e microcefalia
Won Sriwijitalai
1  RVT Medical Center, Bangkok, Thailand
Viroj Wiwanitkit
2  Joseph Ayobabalola University, Lagos, Nigeria
› Author Affiliations
Further Information

Publication History

08 June 2017

30 June 2017

Publication Date:
16 January 2018 (online)

Dear Editor,

The publication by Duarte et al[1] on “Zika Virus Infection in Pregnant Women and Microcephaly” is very interesting. Duarte et al[1] mentioned that “If there are no complications (meningoencephalitis or Guillain-Barré syndrome), further examination is unnecessary to assess systemic impairment” and “Anti-inflammatory drugs should be avoided until the diagnosis of dengue is discarded.” We would like to discuss on these two interesting points. First, there is no doubt regarding the fact that most cases of Zika virus infection are asymptomatic.[2] However, this does not mean that the asymptomatic Zika virus infection does not present any hidden abnormalities. In a recent publication, it was clearly shown that there are many cases with congenital Zika virus syndrome that present no microcephaly but many abnormalities in the brain-from-brain imaging evaluation.[3] If we overlooked the complete clinical assessment of the asymptomatic cases, we might miss many hidden problems that can result in future unwanted events. Focusing on the recommendation to avoid anti-inflammatory drugs, there is no contraindication to the use of anti-inflammatory drug in the patients with dengue,[4] and there is also no evidence that the use of anti-inflammatory drugs provides any clinical advantage in cases of Zika virus infection.