A 24-Year-Old Woman, Gravida 1 Para 0, at 26 Weeks

A 24-year-old woman, gravida 1 para 0, at 26 weeks gestation comes to the emergency department due to abdominal cramping and vaginal bleeding.  She recently emigrated from Bolivia and reports no prior medical problems.  The patient's only medication is a daily multivitamin.  Immunization status is unknown.  The patient spontaneously delivers a stillborn fetus with multiple congenital malformations.  Fetal autopsy reveals microcephaly with thin cerebral cortices, ventriculomegaly, and subcortical calcifications.  Viral RNA of a neurotropic virus is detected in body fluids of the mother and the fetus.  Transplacental transmission of this virus causes apoptosis of neural progenitor cells in the developing fetus, leading to disruption of neuronal proliferation, migration, and differentiation.  Which of the following viruses most likely caused this patient's in utero infection?

A) Cytomegalovirus
B) Herpes simplex virus
C) Parvovirus B19
D) Rubella virus
E) Varicella zoster virus
F) Zika virus

Correct Answer:

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