VZV, Varicella, Chicken Pox
In general, Clinical manifestations of TORCH infections include:
–IUGR, congenital malformations
–Non-immune hydrops, thrombocytopenia, anemia
Human immunodeficiency virus (HIV) and herpes
simplex virus usually are acquired at the time of delivery, and the infant
generally is asymptomatic at birth. Therefore, maternal HIV serology and viral
culture of swabs from the infant’s throat and conjunctivae for HSV are unlikely
to yield a diagnosis. Congenital syphilis also rarely is symptomatic at birth,
although the most common symptoms include rash, snuffles, and bony changes.
Diagnostic testing is the best means to distinguish CMV infection from toxoplasmosis because many of their clinical features overlap. Toxoplasmosis is more apt to present with chorioretinitis and scattered cerebral calcifications; CMV infection more frequently is associated with periventricular calcifications. CMV is diagnosed best by culture of the infant’s urine in the first 3 to 4 weeks of life. Serologic testing of maternal and infant sera is the best method for diagnosing congenital toxoplasmosis, but it is less useful in identifying CMV infection.
CHLA Board Review 2005
American Academy of Pediatrics. Toxoplasma gondii infections. In: Pickering LK, ed. 2000 Red Book: Report of the Committee on Infectious Diseases. 25th ed. Elk Grove Village, Ill: American Academy of Pediatrics; 2000:583-586
Boyer KM, Remington JS, McLeod RL. Toxoplasmosis. In: Feigin RD, Cherry JD, eds. Textbook of Pediatric Infectious Diseases. 4th ed. Philadelphia, Pa: WB Saunders Co; 1998:2473-2490
Lynfield R, Guerina NG. Toxoplasmosis. Pediatr Rev. 1997;18:75-83
Remington JS, McLeod R, Desmonts G. Toxoplasmosis. In: Remington JS, Klein JO, eds. Infectious Diseases of the Fetus & Newborn Infant. 4th ed. Philadelphia, Pa: WB Saunders Co; 1995:140-247