1/29/23, 1:22 AM Congenital TORCH infections - AMBOSS

Overview of congenital TORCH infections

Infection Clinical features Diagnosis Treatment Prevention

Avoidance of uncooked
Classic triad
meat
Chorioretinitis
Avoidance of handling cat
Hydrocephalus T. gondii-specific IgM antibodies Pyrimethamine, sulfadiazine,
Toxoplasmosis feces
Diffuse intracranial calcifications PCR for T. gondii DNA and folinic acid
Immediate administration
(ring-enhancing lesions)
of spiramycin to prevent
Petechiae and purpura (blueberry muffin rash)
of fetal toxoplasmosis

Early congenital syphilis (onset < 2 years)

Jaundice and hepatosplenomegaly
Lymphadenopathy
Nasal discharge (sniffles)
Maculopapular rash
VDRL or RPR
Skeletal abnormalities Treatment of mother in
Syphilis Dark-field microscopy Penicillin
Late congenital syphilis (onset > 2 years) early pregnancy 
PCR
Frontal bossing, rhagades
Hutchinson teeth
Interstitial keratitis
Sensorineural deafness
Saber shins

Avoidance of
Spontaneous abortion and premature birth
unpasteurized dairy
Meningitis, sepsis
Listeriosis Bacterial culture Ampicillin and gentamicin products
Vesicular and pustular skin lesions
Avoidance of cold deli
(granulomatosis infantiseptica)
meats

IUGR, premature birth
Chorioretinitis, cataract Direct fluorescent antigen test Varicella-zoster immune Active immunization of

Varicella zoster Encephalitis (DFA) globulin (VZIG) mother before pregnancy 

virus (VZV) Pneumonia PCR for VZV DNA Acyclovir Passive
CNS abnormalities Serology (IgM antibodies) Breastfeeding immunization with VZIG [1]
Hypoplastic limbs

Frequent hand washing

PCR for parvovirus B19 DNA Avoid potentially
Aplastic anemia Intrauterine fetal blood
Parvovirus B19 Serial ultrasounds to rule contaminated workplaces
Fetal hydrops transfusion if indicated
out fetal hydrops (e.g., schools, pediatric
clinics)

IUGR
Active immunization of
Sensorineural deafness 
mother before pregnancy 
Cataracts
Serology (IgM antibodies) Second immunization of
Rubella Heart defects (e.g., PDA, pulmonary Supportive care
PCR for rubella RNA mother after delivery if
artery stenosis)
serologic titers remain
CNS abnormalities
negative
Petechiae and purpura (blueberry muffin rash)

Jaundice, hepatosplenomegaly
IUGR
Frequent hand washing
Chorioretinitis
Avoid potentially
Sensorineural deafness Viral culture Ganciclovir and valganciclovir
Cytomegalovirus (CMV) contaminated workplaces
Periventricular calcifications  PCR for CMV DNA Supportive care
(e.g., schools, pediatric
Petechiae and purpura (blueberry muffin rash)
clinics)
Microcephaly
Seizures

Herpes simplex Premature birth, IUGR Viral culture Acyclovir Cesarean delivery if

virus (HSV) Skin, eyes, and mouth involvement: vesicular PCR for HSV DNA Supportive care lesions are present at
lesions, keratoconjunctivitis delivery
Localized CNS involvement: meningoencephalitis

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1/29/23, 1:22 AM Congenital TORCH infections - AMBOSS

Overview of congenital TORCH infections

Infection Clinical features Diagnosis Treatment Prevention

Multiple organ involvement, sepsis

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