The 3 largest case series of infants with microcephaly also reporting congenital contractures found that, among 35, 48, and 52 infants with microcephaly and presumed congenital ZIKV infection, isolated clubfoot occurred in 14 %, 10.4 %, and 3.8 % and arthrogryposis in 11 %, 10.4 %, and 5.7 %, respectively.36 - 38 Among a series of 104 infants under clinical investigation, 7 (6.7 %) with presumed (5 infants) and laboratory - confirmed (2 infants) congenital ZIKV infection had arthrogryposis; 6 of these infants had a head circumference of at least 2 SD below the mean.41 All had bilateral congenital hip dislocation, which previously has been reported to occur in 30 % to 40 % of children
with arthrogryposis of various etiologies and 3 of 7 had dislocation or partial dislocation of 1 or both knees.41, 57
Most children
with arthrogryposis have typical thinking and language skills.
Not exact matches
The researchers said these cases of
arthrogryposis were possibly connected to the nervous system, which is consistent
with some of the other birth defects linked to Zika.
Congenital contractures involving 1 or multiple joints (ie,
arthrogryposis multiplex congenita or
arthrogryposis) have been reported in fetuses and infants
with presumed or laboratory - confirmed congenital ZIKV infection.20, 24,36,37,41 The clinical picture of congenital contractures varies among affected infants in regard to type (proximal or distal), laterality, upper or lower limb, and severity, likely reflecting variations in neurologic damage (Figure 4).