ABSTRACT
Existen numerosas infecciones bacterianas, virales y parasitarias que pueden transmitirse desde la madre al feto o recién nacido (RN) y que significan un riesgo para él. El acrónimo TORCH se utiliza en forma universal para caracterizar a aquel feto o RN que presenta un cuadro clínico compatible con una infección congénita y que permite un enfrentamiento racional, tanto diagnóstico como terapéutico. El concepto tradicional de realizar un "test de TORCH" sin consideraciones específicas a cada paciente, hoy en día se considera no adecuado y ha sido reemplazado por exámenes específicos para patógenos específicos bajo circunstancias bien definidas. El presente documento revisa las características generales, epidemiológicas, patogénicas, diagnósticas y terapéuticas de los patógenos más frecuentemente involucrados en el estudio de pacientes con sospecha de TORCH.
There is a lot of bacterial, viral or parasite infections who are able to be transmitted vertically from the mother to the fetus or newborn which implicates an enormous risk for it. The TORCH acronym is used universally to refer to a fetus or newborn which presents clinical features compatible with a vertically acquired infection and allows a rational diagnostic and therapeutic approach. The traditional "TORCH test" is nowadays considered not appropriate and it has been replaced for specific test for specific pathogens under well defined circumstances. The present document reviews the general characteristics, epidemiology, pathogenesis, diagnostic and therapeutic options for the most frequently involved pathogens in the fetus or newborn with TORCH suspicion.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Toxoplasmosis/diagnosis , Chagas Disease/epidemiology , Cytomegalovirus Infections/congenital , Chile , Toxoplasmosis/therapy , Toxoplasmosis/epidemiology , Neonatal Screening/methods , Practice Guideline , Chagas Disease/therapy , Cytomegalovirus Infections/diagnosis , Infectious Disease Transmission, Vertical , Herpes Simplex/congenital , Herpes Simplex/epidemiology , Measles/congenital , Measles/epidemiologyABSTRACT
There is a lot of bacterial, viral or parasite infections who are able to be transmitted vertically from the mother to the fetus or newborn which implicates an enormous risk for it. The TORCH acronym is used universally to refer to a fetus or newborn which presents clinical features compatible with a vertically acquired infection and allows a rational diagnostic and therapeutic approach. The traditional "TORCH test" is nowadays considered not appropriate and it has been replaced for specific test for specific pathogens under well defined circumstances. The present document reviews the general characteristics, epidemiology, pathogenesis, diagnostic and therapeutic options for the most frequently involved pathogens in the fetus or newborn with TORCH suspicion.
Existen numerosas infecciones bacterianas, virales y parasitarias que pueden transmitirse desde la madre al feto o recién nacido (RN) y que significan un riesgo para él. El acrónimo TORCH se utiliza en forma universal para caracterizar a aquel feto o RN que presenta un cuadro clínico compatible con una infección congénita y que permite un enfrentamiento racional, tanto diagnóstico como terapéutico. El concepto tradicional de realizar un "test de TORCH" sin consideraciones específicas a cada paciente, hoy en día se considera no adecuado y ha sido reemplazado por exámenes específicos para patógenos específicos bajo circunstancias bien definidas. El presente documento revisa las características generales, epidemiológicas, patogénicas, diagnósticas y terapéuticas de los patógenos más frecuentemente involucrados en el estudio de pacientes con sospecha de TORCH.
Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Infant, Newborn, Diseases/microbiology , Infant, Newborn, Diseases/parasitology , Infant, Newborn, Diseases/virology , Pregnancy Complications, Infectious/microbiology , Pregnancy Complications, Infectious/parasitology , Pregnancy Complications, Infectious/virology , Prenatal Diagnosis , Rubella/congenital , Rubella/diagnosis , Rubella/therapy , Syndrome , Toxoplasmosis, Congenital/diagnosis , Toxoplasmosis, Congenital/therapy , Risk Factors , Chagas Disease/congenital , Chagas Disease/diagnosis , Chagas Disease/therapy , Practice Guidelines as Topic , Cytomegalovirus Infections/congenital , Cytomegalovirus Infections/diagnosis , Cytomegalovirus Infections/therapy , Fetus , Herpes Simplex/congenital , Herpes Simplex/diagnosis , Herpes Simplex/therapySubject(s)
Humans , Pregnancy , Infant, Newborn , Adult , Pregnancy Complications, Infectious , Parvovirus B19, Human , Cytomegalovirus Infections/congenital , Cytomegalovirus Infections/diagnosis , Cytomegalovirus Infections/drug therapy , Cytomegalovirus Infections/transmission , Infectious Disease Transmission, Vertical , Enterovirus Infections/transmission , Herpes Simplex/congenital , Herpes Simplex/diagnosis , Herpes Simplex/physiopathology , Herpes Simplex/drug therapy , Herpes Simplex/transmission , Syphilis, Congenital/diagnosis , Syphilis, Congenital/physiopathology , Syphilis, Congenital/drug therapy , Syphilis, Congenital/transmissionSubject(s)
Humans , Female , Pregnancy , Infant, Newborn , Infant , Pediatrics , Infectious Disease Transmission, Vertical , Fetus , Pregnancy Complications, Infectious , Diagnosis, Differential , Infant, Newborn, Diseases , Communicable Diseases/diagnosis , Chickenpox/congenital , Parvovirus B19, Human , Cytomegalovirus Infections/congenital , Hepatitis B/congenital , Herpes Simplex/congenital , Infectious Mononucleosis/congenital , Malaria/congenital , Chagas Disease/complications , Enterovirus Infections/congenital , Parvoviridae Infections/congenital , Syphilis, Congenital/diagnosis , Rubella Syndrome, Congenital , Acquired Immunodeficiency Syndrome/congenital , Toxoplasmosis, Congenital/diagnosisSubject(s)
Humans , Pregnancy , Infant, Newborn , Female , Chickenpox/drug therapy , Cytomegalovirus Infections/diagnosis , Herpes Simplex/drug therapy , Patient Care Management/standards , Pregnancy Complications, Infectious/therapy , Rubella Syndrome, Congenital/diagnosis , Algorithms , Chickenpox/complications , Chickenpox/congenital , Cytomegalovirus Infections/complications , Cytomegalovirus Infections/transmission , Fetus , Herpes Simplex/congenital , Herpes Simplex/transmission , Herpesvirus 3, Human , Simplexvirus/isolation & purification , Simplexvirus/pathogenicitySubject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Communicable Diseases/congenital , Infant, Newborn, Diseases , Chlamydia , Diarrhea, Infantile , Gonorrhea , Hepatitis B/congenital , Herpes Simplex/congenital , Infant Mortality , Infections , Meningitis , Syphilis, Congenital , Tetanus/congenitalSubject(s)
Cytomegalovirus Infections/congenital , Female , Herpes Simplex/congenital , Humans , Infant, Newborn , Infections/congenital , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Prenatal Exposure Delayed Effects , Rubella Syndrome, Congenital/diagnosis , Toxoplasmosis, Congenital/diagnosisSubject(s)
Humans , Male , Female , Infant, Newborn , Herpes Simplex/congenital , Herpes Simplex/complicationsABSTRACT
An autopsy case of disseminated HSV type 2 infection occurring in a neonate at 32 weeks' gestation, delivered by cesarean section after premature rupture of membrane of 7 days duration, is presented. Herpes simplex virus type 2 was isolated from the vesicular skin lesion. The mother and patient had specific antibody to type 2 herpes simplex virus. Patient's parents had denied any herpetic orolabial or genital lesion during or before this pregnancy. Cultures from the cervical and vaginal swabs of the mother were negative for HSV. Postmortem examination showed hepatic necrosis, skin vesicle, devastating necrotizing inflammation of the brain, chorioretinitis and interstitial pneumonitis.
Subject(s)
Humans , Infant, Newborn , Male , Autopsy , Brain/pathology , Encephalitis/etiology , Herpes Simplex/congenital , Infant, Premature, Diseases/pathology , Liver/pathology , Necrosis , Skin/pathologyABSTRACT
Herpes simplex virus (HSV) was detected by the enzyme-linked immunosorbent assay (ELISA). The assay system employed rabbit anti-HSV-2-coated microplates to detect HSV in clinical specimens and the same reagent labelled with peroxidase as a conjugate. The HSV type 2 obtained from vero cell culture and normal cell lysate (NCL) were used as positive and negative reference antigens respectively. HSV was detected in 40 (9.93%) of vaginal swabs obtained from 403 pregnant women just before the deliveries and in 39 (9.68%) fluid samples collected immediately after birth from the mouths of 403 newborns. HSV was detected in five pairs of mother-newborn under investigation. There was no correlation between the incidence of HSV in mothers and newborns (p greater than 0.05).