Congenital Zika virus infection cause microcephaly and severe brain abnormalities. Congenital Zika syndrome comprises a spectrum of clinical features. As more information about the associated clinical syndrome becomes available, the phenotype is expanding to include other, sometimes less severe features, such as brain abnormalities without congenital microcephaly.

Initial descriptions of the effects of in utero Zika virus infection centered prominently on the finding of congenital microcephaly. To assess the possibility of clinical presentations that do not include congenital microcephaly, a retrospective assessment of 13 infants from the Brazilian states of Pernambuco and Ceará with normal head size at birth and laboratory evidence of congenital Zika virus infection was conducted. Microcephaly For this report, microcephaly was defined as head circumference (HC) (also known as…