TORCH complex

WikiDoc Resources for TORCH complex
Articles
Most recent articles on TORCH complex Most cited articles on TORCH complex Review articles on TORCH complex Articles on TORCH complex in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on TORCH complex Images of TORCH complex Photos of TORCH complex Podcasts & MP3s on TORCH complex Videos on TORCH complex
Evidence Based Medicine
Cochrane Collaboration on TORCH complex Bandolier on TORCH complex TRIP on TORCH complex
Clinical Trials
Ongoing Trials on TORCH complex at Clinical Trials.gov Trial results on TORCH complex Clinical Trials on TORCH complex at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on TORCH complex NICE Guidance on TORCH complex NHS PRODIGY Guidance FDA on TORCH complex CDC on TORCH complex
Books
Books on TORCH complex
News
TORCH complex in the news Be alerted to news on TORCH complex News trends on TORCH complex
Commentary
Blogs on TORCH complex
Definitions
Definitions of TORCH complex
Patient Resources / Community
Patient resources on TORCH complex Discussion groups on TORCH complex Patient Handouts on TORCH complex Directions to Hospitals Treating TORCH complex Risk calculators and risk factors for TORCH complex
Healthcare Provider Resources
Symptoms of TORCH complex Causes & Risk Factors for TORCH complex Diagnostic studies for TORCH complex Treatment of TORCH complex
Continuing Medical Education (CME)
CME Programs on TORCH complex
International
TORCH complex en Espanol TORCH complex en Francais
Business
TORCH complex in the Marketplace Patents on TORCH complex
Experimental / Informatics
List of terms related to TORCH complex

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: TORCHES; TORCH infections

Overview

TORCH Complex is a medical acronym for a set of 5 congenital infections (i.e. that are passed from an infected mother to her fetus).

Conditions

The diseases present similarly, involving the heart, skin, eye, and CNS. They all cause chorioretinitis, microcephaly, and focal cerebral calcification.

It is possible for genetic conditions (Aicardi-Goutieres syndrome) to present in a similar manner.

TORCHES infections are a group of infections that in a pregnant woman can lead to severe fetal anomalies or even fetal loss. They are a group of viral, and rarely bacterial infections, which gain access to the fetal bloodstream transplacentally via the chorionic villi. Hematogenous transmission may occur any time during gestation or occasionally -as with HIV and Hep B- at the time of delivery via maternal-to-fetal transfusion. The mother often has a mild infection with few or no symptoms. TORCH is an acronym.

The infections are:

1. T – Toxoplasmosis / Toxoplasma gondii
2. O – Other infections (see below)
3. R – Rubella
4. C – Cytomegalovirus
5. H – HErpes simplex virus

The "O" can stand for "other agents", namely Hepatitis B, Syphilis, Varicella-Zoster Virus, HIV, and Parvovirus B19.

Listeria, E. coli and group B streptococci can also be acquired after membrane rupture and are the 3 most common causes of meningitis of the newborn.

The acronym has also been listed as TORCHES, for Toxoplasmosis, Rubella, CMV, Herpes simplex, Syphilis.

Natural History, Complications and Prognosis

Prognosis

Each type of TORCH infection has a different prognosis. The stage of the pregnancy at the time of infection also can change the effect on the newborn.

Diagnosis

History and Symptoms

Symptoms of a TORCH infection may include fever and poor feeding. The newborn is often small for gestational age. A petechial rash on the skin may be present, with small reddish or purplish spots due to bleeding from capillaries under the skin. An enlarged liver and spleen (hepatosplenomegaly) is common, as is the yellowish discoloration of the skin and eyes called jaundice. Hearing impairment, eye problems, mental retardation, autism, and death can be caused by TORCH infections.

Physical Examiantion

When physical examination of the newborn shows signs of the TORCH syndrome, the examiner may test blood, urine, and spinal fluid for evidence of the infections listed above. Diagnosis can be confirmed by culture of one of the specific pathogens or by increased levels of IgM against the pathogen.

Treatment

Medical Therapy

Some of the TORCH infections, such as toxoplasmosis and syphilis, can be effectively treated with antibiotics if the mother is diagnosed early in her pregnancy. Many of the viral TORCH infections have no effective treatment.

Prevention

Notably rubella and varicella-zoster, can be prevented by vaccinating the mother prior to pregnancy. If the mother has active herpes simplex, delivery by Caesarean section can prevent the newborn from contact, and consequent infection, with this virus.

References

Template:WikiDoc Sources