TORCH Syndrome

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TORCH syndrome is an infection that occurs in a fetus or newborn that is caused by any of a group of infectious agents such as toxoplasmosis, other agents, rubella (German measles), cytomegalovirus (CMV), and Herpes simplex. Toxoplasmosis is an infectious disease caused by a parasitic organism, Toxoplasma gondii, which can be transmitted to a fetus from an infected mother during pregnancy. Rubella and cytomegalovirus are viral infections. Neonatal herpes is a rare disorder affecting newborns infected with the Herpes simplex virus (HSV). Infection with any of these agents may result in abnormalities in a developing fetus.

Symptoms of TORCH syndrome are many and varied and may include difficulty feeding, lethargy, fever, small areas of bleeding under the skin (petechiae), enlarged liver and spleen (hepatosplenomegaly), jaundice (yellowing of skin, eyes, and mucous membranes), low hemoglobin, anemia, hearing loss, eye abnormalities and inflammation (chorioretinitis), and other symptoms and conditions, depending on the type of infectious organism and stage of fetal development. An infection with a TORCH agent during pregnancy may cause miscarriage, stillbirth, delayed fetal growth (intrauterine growth retardation), and premature delivery. Infection with toxoplasmosis during pregnancy may result in an infant with an abnormally small head (microcephaly), calcium deposits in the brain, or other abnormalities. Infection with rubella is characterized by fever, upper respiratory infection, swollen lymph nodes, rash, and joint pain. Some newborns and infants may have visual impairment or hearing loss, heart defects, calcium deposits in the brain, or other abnormalities. A cytomegalovirus infection may cause growth retardation, abnormally small head (microcephaly), hemolytic anemia, calcium deposits in the brain, and/or other abnormalities. Infection with the Herpes simplex virus may cause fluid-filled blisters on the skin (cutaneous vesicles), mouth lesions, eyelid and eye inflammation (conjunctivitis), muscle weakness, hepatitis (liver inflammation), difficulty breathing, and/or other symptoms.

Treatment for TORCH syndrome depends on the cause of the infection, the stage of fetal development when the infection occurred, the severity of the infection, and any associated symptoms and/or abnormalities. Infants with toxoplasmosis infection may be treated with the combined drug, pyrimethamine with sulfadiazine, while a Herpes simplex infection may be treated with the antiviral drug, acyclovir. Treatment for newborns and infants with rubella or cytomegalovirus infection is determined by the symptoms and includes supportive care.