Study of TORCH infections and its impact on newborn babies and infants: a retrospective study in a tertiary care hospital in Visakhapatnam, Andhra Pradesh, India

Sai Prabha Chilakala; Appa Rao P.; Ramalakshmi K.; Suresh Babu Chaduvula

doi:10.18203/2320-6012.ijrms20205316

Authors

Sai Prabha Chilakala Department of Microbiology, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
Appa Rao P. Department of Microbiology, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
Ramalakshmi K. Department of Microbiology, Andhra Medical College, Visakhapatnam, Andhra Pradesh, India
Suresh Babu Chaduvula Department of Obstetrics and Gynaecology, GIMSR, Visakhapatnam, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20205316

Keywords:

TORCH- Toxoplasma, Others, Rubella, Cytomegalovirus, Herpes simplex

Abstract

Background: TORCH is an acronym for Toxoplasma, others (syphilis), Rubella, Cytomegalovirus and Herpes simplex virus. These are important causes of morbidity and mortality in new-borns, infants and children. Early diagnosis and treatment are essential to reduce the morbidity and mortality.

Methods: It was a cross sectional record based retrospective record-based study conducted in King George Hospital, Andhra Medical College, Visakhapatnam, Andhra Pradesh. Samples from clinically suspected cases (newborns and infants) for possible TORCH infections were tested in virology laboratory from January to November 2019 and the samples were collected and tested by EUROIMMUN kit for the respective IgM antibodies and analyzed. Clinical details of newborns and infants were gathered from the patients through telephonic communication.

Results: Total number of patients tested were 104 in which 54 (52%) showed positivity in which 36 were positive for CMV, 25 for HSV₂, 23 for Rubella, 12 for Toxoplasma and 11 for Varicella zoster infection. Out of 52 positive cases 20.4% were alive and normal, 20% were alive but severely affected, mortality was 16.7%. Out of 16.7% mortalities 22% of deaths were due to nephrotic syndrome. Clinical manifestations include hepato-splenomegaly in 33.3% cases, fever in 30%, low birth weight in 25%, heart disease in 13.7%, microcephaly in 13.7%.

Conclusions: Our study showed hepatomegaly, fever and low birth weight as common clinical manifestations. Fever and nephrotic syndrome were typically associated with CMV positive cases. Out of 52 % positively tested cases CMV was very common infection followed by HSV₂, Rubella and Toxoplasmosis.

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References

Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison’s Principles of Internal Medicine. 20th edn. Mc Graw Hill; 2020:365,1361-62,1478,1609.

Singh S, Munawwar A, Rao S, Mehta S, Hazarika NK. Serologic prevalence of Toxoplasma gondii in Indian women of child bearing age and effects of social and environmental factors. PLoS Negl Trop Dis. 2014;8(3):e2737.

Lee JY, Bowden DS. Clinical Microbiology Reviews. Clin Microbiol Rev. 2000;13(4):571-87.

Dewan P, Gupta P. Burden of congenital rubella syndrome (CRS) in India: a systematic review. Indian Paediatr. 2012;49:377-99.

Cherry J, Demmler-Harrison G, Kaplan S, Steinbach W, Hotez P. Feigin and Cherry’s Textbook of Pediatric Infectious Diseases. 8th edn. Vol. 1. Elsevier; 2017:1431

Lanzieri TM, Dollard SC, Bialek SR, Grosse SD. Systematic review of the birth prevalence of congenital cytomegalovirus infection in developing countries. Int J Infect Dis. 2014;22:44-8.

Manicklal S, Emery VC, Lazzarotto T, Boppana SB, Gupta RK. The “silent” global burden of congenital cytomegalovirus. Clin Microbiol Rev. 2013;26(1):86-102.

Loeffelholz M, Hodinka RL, Young SA, Pinksy BA, eds. Clinical virology manual. 5th edn. ASM Press; 2016:365.

Schneider JA, Lakshmi V, Dandonaetal R. Population-based seroprevalence of HSV-2 and syphilis in Andhra Pradesh state of India. BMC Infect Dis. 2010;10:59.

Prasoona KR, Srinadh B, Sunitha T, Sujatha M, Deepika ML, Lakshmi BV, et al. Seroprevalence and influence of torch infections in high risk pregnant women: a large study from South India. J Obstet Gynecol India. 2015;65(5):301-9.

Suzuki Y, Toribe Y, Mogami Y, Yanagihara K, Nishikawa M. Epilepsy in patients with congenital cytomegalovirus infection. Brain Dev. 2008;30(6):420-4.

Boppana SB, Pass RF, Britt WJ, Stagno S, Alford CA. Symptomatic congenital cytomegalovirus infection: neonatal morbidity and mortality. Pediatr Infect Dis J. 1992;11(2):93-9.

Besbas N, Bayrakci US, Kale G, Cengiz AB, Akcoren Z, Akinci D, et al. Cytomegalovirus-related congenital nephrotic syndrome with diffuse mesangial sclerosis. Pediatr Nephrol. 2006;21(5):740-2.

Kylat RI, Kelly EN, Ford-Jones EL. Clinical findings and adverse outcome in neonates with symptomatic congenital cytomegalovirus (SCCMV) infection. Eur J Pediatr. 2006;165(11):773-8.