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TORCH Infections
Blaise V. Jones, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        TERMINOLOGY

        • Synonyms

          • Congenital infections, intrauterine infection, TORCHES
        • Definitions

          • Acronym for congenital infections caused by transplacental transmission of pathogens
            • Toxoplasmosis (toxo) → Toxoplasma gondii
            • Other (Zika → Zika virus)
            • Rubella → rubella virus
            • Cytomegalovirus (CMV) → most common TORCH infection
            • Herpes → herpes simplex virus 2 (HSV-2)
            • Human immunodeficiency virus (HIV)
            • Syphilis → Treponema pallidum

        IMAGING

        • General Features

          • CT Findings

            • MR Findings

              • Ultrasonographic Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Gross Pathologic & Surgical Features

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Clinical features and neuroimaging (CT and MRI) findings in presumed Zika virus related congenital infection and microcephaly: retrospective case series study. BMJ. 353:i3182, 2016
                                    2. Alarcon A et al: A prognostic neonatal neuroimaging scale for symptomatic congenital cytomegalovirus infection. Neonatology. 110(4):277-285, 2016
                                    3. Besnard M et al: Congenital cerebral malformations and dysfunction in fetuses and newborns following the 2013 to 2014 Zika virus epidemic in French Polynesia. Euro Surveill. 21(13), 2016
                                    4. Dhombres F et al: Prognosis of fetal parenchymal cerebral lesions without ventriculomegaly in congenital toxoplasmosis infection. Fetal Diagn Ther. ePub, 2016
                                    5. Flores MS et al: Zika virus: a primer for clinicians. Cleve Clin J Med. 83(4):261-70, 2016
                                    6. Guillemette-Artur P et al: Prenatal brain MRI of fetuses with Zika virus infection. Pediatr Radiol. 46(7):1032-9, 2016
                                    7. Inaba Y et al: Correlation between white matter lesions and intelligence quotient in patients with congenital cytomegalovirus infection. Pediatr Neurol. 55:52-7, 2016
                                    8. Oosterom N et al: Neuro-imaging findings in infants with congenital cytomegalovirus infection: relation to trimester of infection. Neonatology. 107(4):289-96, 2015
                                    9. Nickerson JP et al: Neuroimaging of pediatric intracranial infection--part 2: TORCH, viral, fungal, and parasitic infections. J Neuroimaging. 22(2):e52-63, 2012
                                    10. de Jong EP et al: Is routine TORCH screening warranted in neonates with lenticulostriate vasculopathy? Neonatology. 97(3):274-8, 2010
                                    11. Bale JF et al: Herpes simplex virus infections of the newborn. Curr Treat Options Neurol. 7(2):151-156, 2005
                                    12. de Vries LS et al: The spectrum of cranial ultrasound and magnetic resonance imaging abnormalities in congenital cytomegalovirus infection. Neuropediatrics. 35(2):113-9, 2004
                                    13. Jones J et al: Congenital toxoplasmosis. Am Fam Physician. 67(10):2131-8, 2003
                                    14. Bale JF Jr: Congenital infections. Neurol Clin. 20(4):1039-60, vii, 2002
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Pathology

                                          TERMINOLOGY

                                          • Synonyms

                                            • Congenital infections, intrauterine infection, TORCHES
                                          • Definitions

                                            • Acronym for congenital infections caused by transplacental transmission of pathogens
                                              • Toxoplasmosis (toxo) → Toxoplasma gondii
                                              • Other (Zika → Zika virus)
                                              • Rubella → rubella virus
                                              • Cytomegalovirus (CMV) → most common TORCH infection
                                              • Herpes → herpes simplex virus 2 (HSV-2)
                                              • Human immunodeficiency virus (HIV)
                                              • Syphilis → Treponema pallidum

                                          IMAGING

                                          • General Features

                                            • CT Findings

                                              • MR Findings

                                                • Ultrasonographic Findings

                                                  • Imaging Recommendations

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • General Features

                                                        • Gross Pathologic & Surgical Features

                                                          • Microscopic Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Clinical features and neuroimaging (CT and MRI) findings in presumed Zika virus related congenital infection and microcephaly: retrospective case series study. BMJ. 353:i3182, 2016
                                                                      2. Alarcon A et al: A prognostic neonatal neuroimaging scale for symptomatic congenital cytomegalovirus infection. Neonatology. 110(4):277-285, 2016
                                                                      3. Besnard M et al: Congenital cerebral malformations and dysfunction in fetuses and newborns following the 2013 to 2014 Zika virus epidemic in French Polynesia. Euro Surveill. 21(13), 2016
                                                                      4. Dhombres F et al: Prognosis of fetal parenchymal cerebral lesions without ventriculomegaly in congenital toxoplasmosis infection. Fetal Diagn Ther. ePub, 2016
                                                                      5. Flores MS et al: Zika virus: a primer for clinicians. Cleve Clin J Med. 83(4):261-70, 2016
                                                                      6. Guillemette-Artur P et al: Prenatal brain MRI of fetuses with Zika virus infection. Pediatr Radiol. 46(7):1032-9, 2016
                                                                      7. Inaba Y et al: Correlation between white matter lesions and intelligence quotient in patients with congenital cytomegalovirus infection. Pediatr Neurol. 55:52-7, 2016
                                                                      8. Oosterom N et al: Neuro-imaging findings in infants with congenital cytomegalovirus infection: relation to trimester of infection. Neonatology. 107(4):289-96, 2015
                                                                      9. Nickerson JP et al: Neuroimaging of pediatric intracranial infection--part 2: TORCH, viral, fungal, and parasitic infections. J Neuroimaging. 22(2):e52-63, 2012
                                                                      10. de Jong EP et al: Is routine TORCH screening warranted in neonates with lenticulostriate vasculopathy? Neonatology. 97(3):274-8, 2010
                                                                      11. Bale JF et al: Herpes simplex virus infections of the newborn. Curr Treat Options Neurol. 7(2):151-156, 2005
                                                                      12. de Vries LS et al: The spectrum of cranial ultrasound and magnetic resonance imaging abnormalities in congenital cytomegalovirus infection. Neuropediatrics. 35(2):113-9, 2004
                                                                      13. Jones J et al: Congenital toxoplasmosis. Am Fam Physician. 67(10):2131-8, 2003
                                                                      14. Bale JF Jr: Congenital infections. Neurol Clin. 20(4):1039-60, vii, 2002