TY  - CHAP
M1  - Book, Section
TI  - TORCH (TORCHZ) Infections
A1  - Gomella, Tricia Lacy
A1  - Eyal, Fabien G.
A1  - Bany-Mohammed, Fayez
PY  - 2020
T2  - Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 8e
AB  - TORCH  is  an  acronym  that  denotes  a  chronic  nonbacterial  perinatal  infection.  It  stands  for  toxoplasmosis,  other  infections,  rubella  virus,  cytomegalovirus  (CMV),  herpes  simplex  virus  (HSV).  The  Zika  virus  (ZIKV)  infection  during  pregnancy  results  in  a  congenital  infection  syndrome  in  the  fetus  and  the  newborn  similar  to  other  TORCH  infections;  manifestations  include  fetal  growth  restriction  (FGR),  microcephaly,  craniofacial  disproportion,  ventriculomegaly,  intracranial  calcification,  optic  nerve  hypoplasia,  and  chorioretinal  atrophy,  among  others.  Thus,  it  has  been  suggested  that  ZIKV  be  added  to  the  TORCH  acronym  to  become  TORCHZ.  “Other”  infections  include  syphilis,  hepatitis  B,  coxsackievirus,  Epstein-Barr  virus,  varicella-zoster  virus  (VZV),  Enterovirus/Parechovirus,  human  immunodeficiency  virus  (HIV),  tuberculosis,  and  parvovirus  B19.  HSV  disease  in  the  neonate  does  not  fit  the  pattern  of  chronic  intrauterine  infection  but  is  traditionally  grouped  with  TORCH.  This  group  of  infections  may  present  in  the  neonate  with  similar  clinical  and  laboratory  findings  (ie,  IUGR,  hepatosplenomegaly,  rash,  central  nervous  system  [CNS]  manifestations  including  calcifications,  early  jaundice,  and  low  platelets),  hence  the  usefulness  of  the  TORCHZ  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  serologic  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  148–1  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  TORCHZ;  therefore,  each  of  these  chapters  has  been  separated  and  listed  as  a  single  chapter.  See  Chapter  149  for  toxoplasmosis,  Chapter  145  for  rubella,  Chapter  132  for  cytomegalovirus,  Chapter  137  for  herpes  simplex  viruses,  Chapter  154  for  ZIKV,  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.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/20
UR  - accesspediatrics.mhmedical.com/content.aspx?aid=1168359010
ER  -