TORCH Flashcards
TORCH syndrome
T= toxoplasmosis O= others ( syphilis, Coxackie, VZV, Parvovirus B19) R= Rubella C= Cytomegaly H= herpes
Symptoms of TORCH syndrome
- Low birth weight (Preterm delivery, intrauterine growth)
- CNS symptoms ( hydrocephalus, microcephaly, intracranial calcification, hypotonia, meningitis)
- Eye disorder( micropthalmy, glaucoma, cataracts, blindness)
- heart defects
- hepatosplenomegaly
- Jaundice
- interstitial pneumonia
- limb malformation
- hematologist disorders: thrombocytopenia, anemia, neutropenia
- Skin changes- Petechiae, hemorrhage, polymorphic rash
- Mental growth retardation
Congenital toxoplasmosis symptoms
- Sabin- Pinkerton’s class is triad
Microcephalia+ chorioretinitis+ intracranial calcification
Toxoplasmosis treatment in neonates
Pyrimethamine
- Loading doses 2mg/Kg for 2days then
- 1mg/Kg per day for 6months then this dose every Monday, Wednesday and Friday
Sulfodiazine
- 100mg/hg per day in divided dose
Leucovorin
- 10 mg three times weekly
Congenital toxoplasmosis treatment
- if symptomatic, continue treatment for 12 months
- if asymptomatic, confirmed by serological testing reduce treatment to 6months
+ if symptoms with CNS involvement then
—prednisolone 1 to 2 mg/Kg
— control CBC, ASPAT i ALAT and urine test
Congenital CMV symptoms
- Hepatosplenomegaly
- Jaundice
- Petechiae
- low birth weight
- chorioretinitis
- interstitial pneumonia
- intracranial calcification
Congenital CMV transmission route
- contact with infected discharge, or via blood transplant organ
- kissing , sexual contacts, sharing food, toys and items contaminated with saliva
Congenital CMV diagnosis
- CMV isolation from urine, stool, saliva or CSF obtained 2 to 4 weeks after deliver
- Detection of antigen pp65 or CMV DNA (PCR, hybridization)
- seroconversion or with positive CMV Ig M, positive IgG and low Ig G avidity
CMV treatment
Treatment not recommended because of higher risk of adverse effects
Only in life threatening cases
- Ganciclovir 2x 6mg/ kg for 2- 6weeks
Non life threatening cases
- valganciclovir for 2 x 16mg/kg for 6 months
VZV infection symptoms
- Damage to optic nerve (micropthalmy, cataracts, chorioretinitis, optic nerve atrophy )
- sensory nerve damage
(Zigzag lesions, hypopigmentation) - spinal cord damage ( limb undergrowth, motor and sensory nerve damage, lack of deep reflexes, asymmetric pupils)
- Brain damage (microcephaly, hydrocephalus, calcification)
VZV prophylaxis
Primary ; seronegative women vaccination ( >3 months of pregnancy)
Secondary - VZIG after exposure to VZV
Acyclovir IV
Congenital rubella syndrome
Gregg’s triad
- Deafness
- Blindness
- Heart defect
- Thrombocytopenia
- Organ defects
Prevention and treatment of rubella
- MMR vaccine
- Gamma globulin 0,5ml/kg , repeat after 2 weeks (half of this dose)
Congenital syphilis symptoms
Vesiculobullous eruptions or macular, copper colored rash on palm and soles and papular lesions around nose and mouth in diaper area as well as Petechial lesion
Congenital syphilis treatment
Aqueous Crystalline Penicillin G
50 000 units/ kg/ dose IV every 12 hrs during first 7days of life and every 8hrs thereafter for a total of 10 days
