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TORCH Infections
Blaise V. Jones, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Diagnostic Checklist

          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. Buca D et al: Outcome of fetuses with congenital cytomegalovirus infection and normal ultrasound at diagnosis: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 57(4):551-9, 2021
                                      2. de Vries LS: Viral infections and the neonatal brain. Semin Pediatr Neurol. 32:100769, 2019
                                      3. Levine D et al: How does imaging of congenital Zika compare with imaging of other TORCH infections? Radiology. 285(3):744-61, 2017
                                      4. 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
                                      5. Alarcon A et al: A prognostic neonatal neuroimaging scale for symptomatic congenital cytomegalovirus infection. Neonatology. 110(4):277-85, 2016
                                      6. Amir J et al: Follow-up of infants with congenital cytomegalovirus and normal fetal imaging. Arch Dis Child Fetal Neonatal Ed. 101(5):F428-32, 2016
                                      7. 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
                                      8. Dhombres F et al: Prognosis of fetal parenchymal cerebral lesions without ventriculomegaly in congenital toxoplasmosis infection. Fetal Diagn Ther. 41(1):8-14, 2016
                                      9. Flores MS et al: Zika virus: a primer for clinicians. Cleve Clin J Med. 83(4):261-70, 2016
                                      10. Guillemette-Artur P et al: Prenatal brain MRI of fetuses with Zika virus infection. Pediatr Radiol. 46(7):1032-9, 2016
                                      11. Inaba Y et al: Correlation between white matter lesions and intelligence quotient in patients with congenital cytomegalovirus infection. Pediatr Neurol. 55:52-7, 2016
                                      12. Oosterom N et al: Neuro-imaging findings in infants with congenital cytomegalovirus infection: relation to trimester of infection. Neonatology. 107(4):289-96, 2015
                                      13. Nickerson JP et al: Neuroimaging of pediatric intracranial infection--part 2: TORCH, viral, fungal, and parasitic infections. J Neuroimaging. 22(2):e52-63, 2012
                                      14. de Jong EP et al: Is routine TORCH screening warranted in neonates with lenticulostriate vasculopathy? Neonatology. 97(3):274-8, 2010
                                      15. Bale JF et al: Herpes simplex virus infections of the newborn. Curr Treat Options Neurol. 7(2):151-156, 2005
                                      16. 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
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Pathology

                                            • Diagnostic Checklist

                                              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. Buca D et al: Outcome of fetuses with congenital cytomegalovirus infection and normal ultrasound at diagnosis: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 57(4):551-9, 2021
                                                                          2. de Vries LS: Viral infections and the neonatal brain. Semin Pediatr Neurol. 32:100769, 2019
                                                                          3. Levine D et al: How does imaging of congenital Zika compare with imaging of other TORCH infections? Radiology. 285(3):744-61, 2017
                                                                          4. 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
                                                                          5. Alarcon A et al: A prognostic neonatal neuroimaging scale for symptomatic congenital cytomegalovirus infection. Neonatology. 110(4):277-85, 2016
                                                                          6. Amir J et al: Follow-up of infants with congenital cytomegalovirus and normal fetal imaging. Arch Dis Child Fetal Neonatal Ed. 101(5):F428-32, 2016
                                                                          7. 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
                                                                          8. Dhombres F et al: Prognosis of fetal parenchymal cerebral lesions without ventriculomegaly in congenital toxoplasmosis infection. Fetal Diagn Ther. 41(1):8-14, 2016
                                                                          9. Flores MS et al: Zika virus: a primer for clinicians. Cleve Clin J Med. 83(4):261-70, 2016
                                                                          10. Guillemette-Artur P et al: Prenatal brain MRI of fetuses with Zika virus infection. Pediatr Radiol. 46(7):1032-9, 2016
                                                                          11. Inaba Y et al: Correlation between white matter lesions and intelligence quotient in patients with congenital cytomegalovirus infection. Pediatr Neurol. 55:52-7, 2016
                                                                          12. Oosterom N et al: Neuro-imaging findings in infants with congenital cytomegalovirus infection: relation to trimester of infection. Neonatology. 107(4):289-96, 2015
                                                                          13. Nickerson JP et al: Neuroimaging of pediatric intracranial infection--part 2: TORCH, viral, fungal, and parasitic infections. J Neuroimaging. 22(2):e52-63, 2012
                                                                          14. de Jong EP et al: Is routine TORCH screening warranted in neonates with lenticulostriate vasculopathy? Neonatology. 97(3):274-8, 2010
                                                                          15. Bale JF et al: Herpes simplex virus infections of the newborn. Curr Treat Options Neurol. 7(2):151-156, 2005
                                                                          16. 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