Atlas of Neonatal Pathology: Intrauterine infections (TORCH group)

+ Introduction

+ Support

+ Neonatal pathology

Intrauterine infections (TORCH group)

Etiology

Congenital infections of fetus and neonate with almost uniform clinical presentation and high risk of permanent handicap in survivors. The organisms spread accros the placenta. Cytomegalovirus is by far the most common.

T — toxoplasmosis
O — others (syphilis, parvovirus B19, varicella zoster etc.)
R — rubella
C — cytomegalovirus
H — herpes simplex

Clinical signs

intrauterine growth retardation or failure to thrive
hydrops fetalis
jaundice or hepatosplenomegaly
skin rash (various)
CNS damage:
- hydrocephalus (CMV, Toxoplamosis) or microcephaly (rubella)
- intracranial calcifications, seizures
eye lesions:
- microphthalmia
- cataracts
- chorioretinitis
visceral lesions:
- pneumonitis
- myocarditis
- encephalitis
- hemolytic anemia
- bone defects (syphilis)
- congenital heart anomalies (rubella)

On the other hand most infants have no apparent illness in the neonatal period but some of them present later during childhood with developemental delay, mental retardation or vision and hearing loss. This is particularly true for CMV infection.