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Monday, December 2, 2013

TORCH Syndrome ----- A Must Read

H.erpes Simplex Virus
TORCH is an acronym for infectious diseases that affect pregnant women in such a way which can cause serious birth defects to an unborn fetus. The following paragraphs include a little blurb about each of these diseases…
Toxoplasmosis is caused by the obligate intracellular sporozoan,Toxoplasma gondii. It can be acquired through ingestion of undercooked meats, or through handling and inhalation of household cat feces. The infectious agent crosses the blood brain barrier of the neonate and deposits within the brain and retina of the eye (since the retina is an extension of neurological tissue). Some possible risk factors include: concurrent HIV infection, immunosuppression (particularly of T cell lines), and congenital infections. The later the exposure and infection of t. gondii, the higher the risk of transmission is to the developing baby. Some warning signs to keep in mind are: history of exposure to undercooked meats or cat feces, and maternal symptoms of significant and sudden headache, seizures, or gait disturbances. In about 21% of neonates, toxoplasmosis can result in serious life threatening conditions, such as impaired cognition or vision. Please consult a medical doctor for appropriate diagnosis and treatment.
Other includes syphilis and other types of infectious diseases, such as HIV, hepatitis b, Listeria, varicella virus, parvovirus B19, etc. Syphilis is a disease caused by a spirochete, Treponema pallidum, that can be vertically transmitted from mom to developing baby though the placenta as early as 6 weeks and can clinically manifest at 18 weeks. Complications can involve pneumonia, preterm delivery, or even stillbirth (at most serious). This TORCH infection can cause blindness, deafness, genetic malformations, and some types of bone lesions within the baby. When the baby is born, a characteristic syphilitic rash is present upon birth. The main pre-term physical history that might indicate a syphilis infection is rash and fever in the mother.
Rubella is a maternal infection that can occur due to viruses such as: Togaviridae and Rubivirus, which can lead to congenital rubella infection within the fetus, occurring as early as the first trimester. Long-term sequelae of infants born with rubella infections include deafness, eye vision disorders, skeletal defects, and reduction in weight gain, as well as cardiovascular effects. Typically infants will be born with characteristic rubella rash and experience cardiovascular effects as well. Upon imaging, some infants even exhibit intracranial calcifications.
Cytomegalovirus (CMV) is a DNA herpesvirus type 5 that commonly causes birth defects,or even death of infants. Women who are exposed to CMV in the first or second trimester have the most deleterious effects. Transmission occurs through congenital occurrences, sexual activity, and exposure to many infected human fluids. (CMV can also be one of the main reasons why an individual develops mononucleosis infection). The two major effects of CMV is that it inhibits T cell responses and is one of the main causes of hearing loss in infants. In our Pediatrics II class, we have learned that hearing loss is the most common birth defect, worldwide. And an associated decreased in hearing potentiates a child to have an overall decrease in school performance, indicating a high likelihood with language deficits and even failing a grade in school.
Herpes simplex virus is the last of the TORCH organisms to cause serious problems in infants exposed to infected mothers. Unlike the last four infectious diseases, herpes virus is transmitted to the neonate primarily though the birth process. The major perpetrator is the herpes simplex virus (HSV) from vesicular lesions within the mother’s genital tract. Complications could range from developmental delay, epilepsy, blindness, cognitive disabilities, or more serious diseases, such as liver failure, adrenal failure, or other blood cell disorders.
This post was not intended as a scare tactic, but as information in oder to bring awareness of the importance of reducing exposure and risk to TORCH viruses and infectious agents during pregnancy, for fear of transmission to the neonate or child before or during the birthing process. Please consult a licensed medical provider for appropriate care if you or a loved one may be suffering from any or all of these viruses.

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