ABSTRACT
Contemporaneous Zika virus (ZIKV) strains can cause congenital Zika syndrome (CZS). Current ZIKV clinical laboratory testing strategies are limited and include IgM serology (which may wane 12 weeks after initial exposure) and nucleic acid testing (NAT) of maternal serum, urine, and placenta for (+) strand ZIKV RNA (which is often transient). The objectives of this study were to determine if use of additional molecular tools, such as quantitative PCR and microscopy, would add to the diagnostic value of current standard placental ZIKV testing in cases with maternal endemic exposure and indeterminate testing. ZIKV RNA was quantified from dissected sections of placental villi, chorioamnion sections, and full cross-sections of umbilical cord in all cases examined. Quantitation with high-resolution automated electrophoresis determined relative amounts of precisely verified ZIKV (74-nt amplicons). In order to localize and visualize stable and actively replicating placental ZIKV in situ, labeling of flaviviridae glycoprotein, RNA ISH against both (+) and (â») ZIKV-specific ssRNA strands, and independent histologic examination for significant pathologic changes were employed. We demonstrate that the use of these molecular tools added to the diagnostic value of placental ZIKV testing among suspected cases of congenital Zika syndrome with poorly ascribed maternal endemic exposure.
Subject(s)
Placenta/pathology , Placenta/virology , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/virology , Zika Virus Infection/diagnosis , Zika Virus Infection/virology , Zika Virus , Adult , Brain/abnormalities , Brain/diagnostic imaging , Female , Humans , Immunohistochemistry , Infectious Disease Transmission, Vertical , Magnetic Resonance Imaging , Microcephaly/diagnosis , Microcephaly/etiology , Phenotype , Pregnancy , Symptom Assessment , Syndrome , Ultrasonography, Prenatal , Young Adult , Zika Virus Infection/transmissionABSTRACT
This is the first case report of subcutaneous emphysema causing a rhegmatogenous retinal detachment. The mechanism by which the eyelid and orbital subcutaneous emphysema caused the retinal detachment is discussed.
Subject(s)
Retinal Detachment/etiology , Subcutaneous Emphysema/complications , Humans , Male , Middle AgedABSTRACT
PURPOSE: To report the clinicopathologic features of an epibulbar osseous choristoma simulating extraocular extension of retinoblastoma. DESIGN: Interventional case report. METHODS: A 7-month-old male presented with a unilateral intraocular mass localized to the temporal retina and a white pedunculated lesion extending from the conjunctiva, anterior to the insertion of the lateral rectus muscle. Clinical examination and computed tomography scan findings led to the diagnosis of retinoblastoma with extraocular extension. The child underwent excision of the epibulbar lesion and enucleation of the globe. RESULTS: The histopathologic examination of the epibulbar lesion revealed an osseous choristoma. The intraocular contents displayed features typical of retinoblastoma without extraocular extension. CONCLUSION: An epibulbar osseous choristoma can simulate extraocular extension of retinoblastoma in an eye harboring the intraocular malignancy.