BrazJOtorhinolaryngol.2017;83(2):239
www.bjorl.org
Brazilian
Journal
of
OTORHINOLARYNGOLOGY
LETTER
TO
THE
EDITOR
Hearing
loss
in
congenital
Zika
virus
夽Perda
auditiva
na
infecc
¸ão
congênita
por
Zika
vírus
DearEditor,
Therecentarticleon‘‘HearinglossincongenitalZikavirus’’ isveryinteresting.1Lealetal.reportedaninterestingcase
of sensorineural hearing loss in a case of congenital Zika virus.1 In fact, it is no doubt that Zika virus can induce
teratogenic effectandthe main pathologyis onthe fetal neurologicalsystem.However,themythistheexact mecha-nismunderlyingthehearinglossinthepresentcase.Infact, thedirectviralinvasionisbelievetobethemain pathogene-sisofneurologicaldefectincongenitalZikavirusinfection.2
In thepresent report, theinteresting concernis the non-fatalbraininvolvementbut neuro-auditorysystem defect. Generally,thebrainpathologyincongenitalZikavirus infec-tion is at cortex3 andnot common at brain stem, hence,
itshouldrarelyinvolvetheneuro-auditorysystem.Indeed, there are many viral infections that can result in con-genitalneurosensory hearinglosssuch asCytomegalovirus (CMV)infection.3 Therearemanypossibleexplanationfor
the present interesting case. In the present case, since there is no clear evidence when the mother got infec-tion,theZikavirus intra-uteroinfectionmight occurafter the brain development. There might also be prior silent
夽 Pleasecitethisarticleas:WiwanitkitV.Hearinglossin
congen-italZikavirus.BrazJOtorhinolaryngol.2017;83:239.
concomitantinfectionthatcanalreadyinvolveauditory sys-tem and induce neurosensory hearing loss (such as CMV infection,whichcanbesilentinthepregnant).4
Conflicts
of
interest
Theauthordeclaresnoconflictsofinterest.
References
1.Leal MC, Muniz LF, Caldas Neto SD, van der Linden V, Ramos RC. Sensorineural hearing lossin a case ofcongenital Zika virus. Braz J Otorhinolaryngol. 2016, http://dx.doi.org/ 10.1016/j.bjorl.2016.06.001,pii:S1808-8694(16)30127-6. 2.WiwanitkitV.Placenta,Zikavirusinfectionandfetalbrain
abnor-mality.AmJReprodImmunol.2016;76:97---8.
3.MlakarJ, KorvaM,Tul N,Popovi´cM,Poljˇsak-PrijateljM,Mraz J,etal.Zikavirusassociatedwithmicrocephaly.NEnglJMed. 2016;374:951---8.
4.Calvani M Jr. Asymptomaticcongenitalcytomegalovirus infec-tion.MinervaPediatr.1991;43:595---600.
VirojWiwanitkit
SurindraRajabhatUniversity,InstituteofNatural
MedicineScienceDevelopmentandEstablishmentProject, SuvannhabhumiClinicalTraining,Researchand
DevelopmentCenter,SurinProvince,Thailand E-mail:wviroj@yahoo.com
http://dx.doi.org/10.1016/j.bjorl.2016.08.007
