First case of acute myelitis in a patient infected with Zika virus

A first case of acute myelitis following infection with Zika virus has been reported for the first time by a research team from Inserm Unit 1127 Brain and Spinal Cord Institute (Inserm/CNRS/Sorbonne University) and neurologists at Pointe-à-Pitre University Hospital and the University of the Antilles. A young patient in the acute phase of an infection by Zika virus presented motor deficiency in the 4 limbs, associated with very intense pain and acute urinary retention. The presence of the virus was confirmed in the cerebrospinal fluid, blood and urine. This case was the subject of a Case report published in The Lancet on 3 March 2016.

In January 2016, a 15-year old girl was admitted to the Pointe-à-Pitre University Hospital in Guadeloupe, with left-side hemiplegia. The girl showed urinary retention on her second day in hospital. The left-side hemiplegia and pain became worse and the doctors recorded a loss of sensation in the legs.

The researchers detected high concentrations of Zika virus in the serum and cerebrospinal fluid on the second day after admission (9 days after the symptoms began). Tests for shingles, chickenpox, herpes virus, legionellosis and mycoplasma pneumonia were negative.

The patient was treated with methylprednisolone (1 g), an anti-inflammatory drug, from the first day and daily for 5 days. Seven days after admission, her neurological condition had improved. At present, the patient is still in hospital but she is out of danger. She has signs of moderate weakness in both legs but is walking unaided again.

For the researchers, "this case strengths the hypothesis regarding the neurotropic nature of the Zika virus. It highlights the existence of neurological complications in the acute phase of the infection, while Guillain Barré syndromes are post-infectious complications. Furthermore, this is a single case. Future studies will be needed."

Source: INSERM (Institut national de la santé et de la recherche médicale)