ICL 14.6: TORCH Infections Flashcards
which agents are TORCH infections?
Toxoplasmosis
Other: syphilis, parvovirus B19, varicella zoster
Rubella
CMV
Histoplasmosis and Herpes
what are TORCH infections?
maternal illness during pregnancy that is transmitted to the fetus across the placenta
can lead to fetal loss or fetal anomalies
it depends on when during the pregnancy the infection happens that determines the effect that they have
what is toxoplasma gondii?
protozoa which mostly lives in felines
ingestion of oocysts by mother that is shed in the stool is how you get it so pregnant women should avoid changing cat litter
can also be transmitted in contaminated soil or by eating undercooked meat from infected animals
transmission to fetus is typically during the PRIMARY maternal infection so there’s no latent infection – mothers are often asymptomatic but can have nonspecific symptoms
what are the symptoms of a toxoplasma infection in the fetus?
may be asymptomatic at birth but still at riks
classic triad:
1. intracranial calcifications
- chorioretinitis
- hydrocephalus
syphilis is caused by what agent?
treponema pallidum
what are the stages of syphilis?
primary: painless chancre
secondary: maculopapular rash on the soles of hands and feet
tertiary: neurosyphilis
what is congenital syphilis?
a syphilis infection that is active during pregnancy (primary or chronic infection) can result in fetal:
- abnormalities of long bones
- maculopapular rash
- rhinorrhea
late findings: gumma formation and scarring can cause saber shins aka bowed legs or saber nose or mulberry/saber teeth
how does coxsackie virus present materially vs fetal?
maternal: rash of skin, especially hands and feet and mucous membranes
fetal disease: cardiac anomalies or stillbirth
RNA virus
how does parvovirus B19 effect the fetus vs adults?
slapped cheek appearance in children
in adults: joint pain, anemia
in fetus: severe destruction of fetal RBCs which causes hydrops fatales = severe anemia causing severe edema/swelling
what is hydrops fatalis?
evere anemia causing severe edema/swelling and death
RBC breakdown due to antibodies crossing the placenta from mom
when is herpes the biggest risk for the fetus?
primary varicella infection during 1st trimester
immunization before pregnancy or having adequate immunity before is so important to protect the fetus
what does herepes do to the fetus when transmitted from the mom?
- scars in a dermatomal fashion
- microcephaly, hydrocephalus, seizures
- eyes: cataracts, CN abnormalities
- limb deformities (rare unless during organogenesis)
- MRDD
how does rubella effect the fetus?
transmitted respiratory droplets and causes maculopapular rash with lymphadenopathy and arthralgia in the mother
fetus is effected with a classic triad:
- congenital deafness
- cataracts
- heart defect (usually PDA)
how does CMV effect the fetus? how is it transmitted?
transmitted via blood, sex, close contact
maternal disease: primary infection typically asymptomatic but can cause mono like illness with fever, pharyngitis and myalgias
fetal disease is usually asymptomatic at birth but can cause congenital hearing loss since it’s the most common infectious cause of congenital sensorineural hearing loss
rarely can cause fetal seizures, poor growth, intracranial calcifications
how does HSV effect the fetus?
STD transmission
fetal disease is transmitted via passage through the vaginal canal (not transplacentally) if there are any vesicles in the vagina – must do c-section if they’re present
vesicles may occur in the fetal mouth, skin and can spread to other organs and eventually cause HSV encephalitis
