TORCH Agents

An acronym for a group of in utero infections—toxoplasmosis and others, e.g., syphilis, rubella, cytomegalovirus (CMV), herpes simplex (HS)—that may induce major foetal malformations and cause prominent and permanent neurologic defects—e.g., seizures, hydrocephalus or microcephaly

TORCH panel

TORCH antibody panel Pediatrics A serologic screen for diagnosing prenatal infection; the finding of ↑ IgM in the neonate implies in utero infection by one of the TORCH agents–toxoplasma, rubella, CMV, herpes simplex, which is then characterized by measuring specific IgM levels.
TORCH agents  
Toxoplasmosis may cause periventricular microglial nodules, thrombosis and necrosis; obstruction of cerebral foramina causes hydrocephalus; with prolonged survival, there is intracranial calcification, hepatocellular, adrenal, pulmonary, cardiac necrosis and extramedullary hematopoiesis
Rubella may cause LBW, hepatosplenomegaly, petechiae and purpura, congenital heart disease, cataracts, microophthalmia and microcephaly; CNS symptoms include lethargy, irritability, dystonia, bulging fontanelles and seizures. See Congenital rubella syndrome.
Cytomegalovirus may cause hepatosplenomegaly, hyperbilirubinemia, neonatal thrombocytopenia, microcephaly and a mortality of 20-30%; later manifestations include mental retardation, deafness, psychomotor delays, dysodontogenesis, chorioretinitis, learning disabilities; ± 33 000 congenital cases/year–US, of which 10% are symptomatic
Herpes simplex may cause prematurity, and becomes symptomatic after the first week of life; CNS symptoms include irritability, seizures, chorioretinitis, hydrocephalus, flaccid or spastic paralysis, opisthotonos, decerebrate rigidity and coma; in neonatal HSV infection, no deaths occur in those with localized disease, 15% die if encephalitis is present and 57% die if HSV is disseminated, potentially evoking DIC NEJM 1991; 324:450
Syphilis–an optional 'TORCH' Congenital syphilis has ↑ to epidemic rates in the urban US since the mid-1980s; the clinical findings are nonspecific and include fever, lethargy, failure to thrive, and irritability  
References in periodicals archive ?
Maternal infections caused by TORCH agents leads to neonatal and fetal mortality.
The transmission risk is higher when the mother becomes infected during the third trimester (transmission rate 60 - 90%) in comparison to infections occurring during the first trimester (transmission rate 10 25%); but, similar to most other TORCH agents, early infections usually result in a poorer fetal outcome, with the majority of first-trimester infections leading to miscarriage.
(5) In addition to micrencephaly, frequent findings in the brains of fetuses affected by TORCH agents include ventriculomegaly, encephalomalacic pseudocysts, atrophic corpus callosum, polymicrogyria, cerebellar hypoplasia, and calcifications, which can usually be detected by neuroimaging.
Most of the torch agents produce syndrome called "Torch Syndrome".
Infections by torch agents in women are usually asymptomatic and chronic.
Detection of antibodies against TORCH agents during pregnancy.
Table 1: Seroprevalence of Toxoplasma gondii Torch agent Seropositivity Seronegativity Total patients Toxoplasma IgM 8(2.7%) 285(97.2%) 293 Toxoplasma IgG 9(5.75%) 148(94.8%) 157 Total 450 Table 2: Seroprevalence of Rubella Torch agent Seropositivity Seronegativity Total patients Rubella IgM 12(5.6%) 200(94.3%) 212 Rubella IgG 68(76.4%) 21(23.5%) 89 Total 68 21 301 Table 3: Seroprevalence of Cytomegalovirus Torch agent Seropositivity Seronegativity Total patients CMV IgM 47(20%) 189(80%) 236 CMV IgG 37(34.9%) 69(65.09%) 106 Total 342 Table 4: Seroprevalence of Herpes simplex Torch agent Seropositivity Seronegativity Total patients HSV IgM 80(24.8%) 242(75.15%) 322 HVS IgG 60(45.8%) 71(54.19%) 131 Total 453 Table 5: Co-prevalence of Various TORCH agents Sl.
Since 1971, the spectrum of pathogens considered to be TORCH agents has greatly expanded.26 Before the current Zika epidemic, a listing of TORCH agents would include such pathogens as syphilis, parvovirus, coxsackievirus, listeriosis, and, in some cases, hepatitis, varicella-zoster virus, Trypanosoma cruzi, enteroviruses, and HIV.
Following fetal infection, TORCH agents can cause a variety of potentially severe complications, which can include microcephaly, multiorgan disease, congenital malformations, and intrauterine growth restriction.
When transmitted from the maternal bloodstream to the fetus through the placenta, most TORCH agents result in recognizable placental abnormalities.
of patients Abortion 38 Intrauterine growth retardation 21 Intrauterine death 09 Preterm labour 07 Early neonatal death 20 Congenital malformation 05 Total 100 Table 3 - Seropositivity of each infection agent within TORCH test Seropositivity Seropositivity HDRF (n=100) Controls (n=5) TORCH agent Number % Number % Toxoplasma 41 41 07 14 Rubella 18 18 02 04 Cytomegalo 27 27 03 06 virus(CMV) Herpes Simplex 14 14 02 04 Virus(HSV) Total 100 100 14 28 Table 4 - TORCH agents with different presentations of HDRF cases.
A positive Ig G antibody test is usually a sign of past-exposure to the TORCH agent and is not a marker for current active infection.