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Infectious causes of microcephaly: epidemiology, pathogenesis, diagnosis, and management.
The Lancet ( IF 168.9 ) Pub Date : 2018-01-01 , DOI: 10.1016/s1473-3099(17)30398-5
Delan Devakumar , Alasdair Bamford , Marcelo U Ferreira , Jonathan Broad , Richard E Rosch , Nora Groce , Judith Breuer , Marly A Cardoso , Andrew J Copp , Paula Alexandre , Laura C Rodrigues , Ibrahim Abubakar

Microcephaly is an important sign of neurological malformation and a predictor of future disability. The 2015-16 outbreak of Zika virus and congenital Zika infection brought the world's attention to links between Zika infection and microcephaly. However, Zika virus is only one of the infectious causes of microcephaly and, although the contexts in which they occur vary greatly, all are of concern. In this Review, we summarise important aspects of major congenital infections that can cause microcephaly, and describe the epidemiology, transmission, clinical features, pathogenesis, management, and long-term consequences of these infections. We include infections that cause substantial impairment: cytomegalovirus, herpes simplex virus, rubella virus, Toxoplasma gondii, and Zika virus. We highlight potential issues with classification of microcephaly and show how some infants affected by congenital infection might be missed or incorrectly diagnosed. Although Zika virus has brought the attention of the world to the problem of microcephaly, prevention of all infectious causes of microcephaly and appropriately managing its consequences remain important global public health priorities.

中文翻译:

小头畸形的感染原因:流行病学,发病机制,诊断和管理。

小头畸形是神经系统畸形的重要标志,也是未来残疾的预测指标。2015-16年爆发寨卡病毒和先天性寨卡病毒感染,引起了全世界对寨卡病毒感染与小头畸形之间联系的关注。然而,寨卡病毒只是小头畸形的感染原因之一,尽管它们发生的环境千差万别,但都值得关注。在这篇综述中,我们总结了可能导致小头畸形的主要先天性感染的重要方面,并描述了这些感染的流行病学,传播,临床特征,发病机理,治疗和长期后果。我们包括引起严重损害的感染:巨细胞病毒,单纯疱疹病毒,风疹病毒,弓形虫和寨卡病毒。我们重点介绍了小头畸形分类的潜在问题,并说明了一些受先天性感染影响的婴儿可能是如何被漏诊或错误诊断的。尽管寨卡病毒已引起全世界对小头畸形问题的关注,但是预防小头畸形的所有传染原因并适当管理其后果仍然是全球公共卫生的重要优先事项。
更新日期:2017-12-21
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