TORCH Infxns

Question 1

TORCH - What is the T?

Answer 1

Toxoplasmosis

Question 2

TORCH - What is the O?

Answer 2

Other (HBV, Syphilis, Parvo, Coxsackie, EBV, VZV)

Question 3

TORCH - What is the R?

Answer 3

Rubella

Question 4

TORCH - What is the C?

Answer 4

CMV (cytomegalovirus)

Question 5

TORCH - What is the H?

Answer 5

HSV (herpes simplex virus)

Question 6

What are the maternal risk factors for toxoplasmosis?

Answer 6

cat feces, undercooked meat (pork), unpasteurized milk

Question 7

What is the NB presentation for toxoplasmosis?

Answer 7

HSM, seizures, intracranial calcifications, hydrocephalus, chorioretinitis

Question 8

What are the maternal risk factors for HBV?

Answer 8

IVDA, multi sex partners, healthcare workers, asian ethnicity

Question 9

What are the fetal affects of HBV?

Answer 9

Increased in premature delivery, low birth wt

Question 10

What is the NB presentation for HBV?

Answer 10

aSx

Question 11

Treatment for NB with HBV?

Answer 11

HBV vaccine & HBIG

Question 12

What are the fetal affects of toxoplasmosis?

Answer 12

Obstruction hydrocephalus, IUGR, ocular dz, CNS dz, abortions, still birth

Question 13

What are the maternal risk factors for VZV (varicella-zoster virus)?

Answer 13

Non-immunized, infxn during 1st 20wksG, infxn btwn 5d before delivery and 2d after delivery

Question 14

What is the NB presentation for VZV (varicella-zoster virus)?

Answer 14

Cutaneous lessons, limb abnl, eye abnl, PNA, encephalopathy, severe mental disability, early death

Question 15

Treatment for NB with VZV?

Answer 15

Tx NB w/ VZIG & isolation

Question 16

What are the fetal affects of Parvovirus B19?

Answer 16

Anemia, CHF, possible hydrops

Question 17

What is the NB presentation for Parvo B19?

Answer 17

Anemia, CHF, possible hydrops or aSx

Question 18

Treatment for NB with Parvo B19?

Answer 18

Supportive Tx

Question 19

What is the NB presentation for syphilis?

Answer 19

Majority are aSx at birth but…maculopapular skin rash, mucopurulent rhinitis (“snuffles”), osteochondritis, lymphadenopathy, hepatomegaly

Question 20

What is syphilis Dx with?

Answer 20

VDRL (Venereal Dz Research Lab), RPR (Rapid Plasma Reagin - want to know mom’s status), FTA-Abs (Fluorescent Treponemal Antibody Absorption)

Question 21

Treatment for NB with syphilis?

Answer 21

PenG

Question 22

What S/S would you see in a child w/ untreated syphilis?

Answer 22

Frontal bossing, Hutchinson’s teeth (peg teeth), saddle bridge nose

Question 23

What is the maternal risk factor for rubella?

Answer 23

Non-immune status

Question 24

When is a fetus most at risk for congenital abnl secondary to a rubella infxn?

Answer 24

1st 20wksG (1st 12wksG = highest risk)

Question 25

What is the NB presentation for rubella?

Answer 25

Hearing loss (sensorineural), cataracts, blueberry muffin rash, congenital heart defect

Question 26

How long can a NB be contagious with rubella? Isolate or no?

Answer 26

Up 1yr - isolate them

Question 27

What is the maternal risk factor for CMV?

Answer 27

Infxn during the 1st half of pregnancy (presents similar to a cold)

Question 28

What is the fetal affect of CMV?

Answer 28

IUGR

Question 29

What is the NB presentation for CMV?

Answer 29

aSx (85-90%)...Sx (10-15%) = petechial rash, microcephaly, periventricular calcifications, hearing loss, mortality secondary to liver F!/DIC/sepsis (20-30%)

Question 30

When is HSV transmission risk the highest?

Answer 30

When there is a primary genital lesion during delivery

Question 31

Congenital HSV - rare or common? Affects?

Answer 31

Rare - affects the fetus's brain, eyes and skin