RT Book, Section
A1 Gomella, Tricia Lacy
A1 Cunningham, M. Douglas
A1 Eyal, Fabien G.
A1 Tuttle, Deborah J.
SR Print(0)
ID 1107525598
T1 TORCH Infections
T2 Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 7e
YR 2013
FD 2013
PB McGraw-Hill Education
PP New York, NY
SN 9780071768016
LK accesspediatrics.mhmedical.com/content.aspx?aid=1107525598
RD 2024/04/19
AB TORCH  is  an  acronym  that  denotes  a  chronic  nonbacterial  perinatal  infection.  It  stands  for  toxoplasmosis,  other  infections,  rubella  virus,  cytomegalovirus  (CMV),  and  herpes  simplex  virus  (HSV).  “Other”  infections  include  syphilis,  hepatitis  B,  coxsackievirus,  Epstein-Barr  virus,  varicella-zoster  virus  (VZV),  enteroviruses,  human  immunodeficiency  virus  (HIV),  tuberculosis,  and  parvovirus  B-19.  Herpetic  disease  in  the  neonate  does  not  fit  the  pattern  of  chronic  intrauterine  infection  but  is  traditionally  grouped  with  the  others.  This  group  of  infections  may  present  in  the  neonate  with  similar  clinical  and  laboratory  findings  (ie,  small  for  gestational  age,  hepatosplenomegaly,  rash,  central  nervous  system  [CNS]  manifestations,  early  jaundice,  and  low  platelets),  hence  the  usefulness  of  the  TORCH  concept.  However,  because  the  “other  infections”  category  of  responsible  pathogens  is  growing  and  becoming  diverse,  the  validity  of  indiscriminate  screening  of  neonates  presenting  with  findings  compatible  with  congenital  infection  using  “TORCH  titers”  has  been  questioned.  Additionally,  some  of  this  serological  testing  yields  both  false-positive  and  false-negative  results.  An  alternative  approach  involves  testing  of  infants  with  suspected  congenital  infections  for  specific  pathogens  based  on  their  clinical  presentation  (see  Table  141–1  and  individual  chapters  on  each  pathogen).  A  high  index  of  suspicion  for  congenital  infection  and  awareness  of  the  prominent  features  of  the  most  common  congenital  infections  help  to  facilitate  early  diagnosis  and  possible  therapy.  Clinicians  are  getting  away  from  the  acronym  TORCH;  therefore,  each  of  these  chapters  has  been  separated  and  listed  as  a  single  chapter.  See  Chapter  142  for  toxoplasmosis,  Chapter  128  for  rubella,  Chapter  90  for  cytomegalovirus,  Chapter  96  for  herpes  simplex  viruses,  and  other  disease-specific  chapters.  See  Appendix  F  for  isolation  precautions  for  all  infectious  diseases,  including  maternal  and  neonatal  precautions,  breast-feeding,  and  visiting  issues.