Herpes Simplex Virus (HSV)
Herpesvirus infections are among the most common viral infections in humans. They are spread by oral or genital contact. It is estimated that between one in 1,000 and one in 5,000 infants are born with HSV infections. About 80 percent of these infections are acquired during the birth process itself; the virus enters the infant through its eyes, skin, mouth, and upper respiratory tract. Of infants born with HSV infection, about 20 percent have localized infections of the eyes, mouth, or skin. About 50 percent of infected infants will develop the disease throughout the body (disseminated) within nine to 11 days after birth. Disseminated herpes infections attack the liver and adrenal glands, as well as other body organs. Without treatment, the mortality rate is 80 percent. Even with antiviral medication, the mortality rate is still 15 to 20 percent, with 40 to 55 percent of the survivors having long-term damage to the central nervous system. In order to begin early, effective treatment, it is critical for pediatricians to diagnose HSV infection in newborns as soon as possible.
Performing the TORCH panel requires obtaining a sample of the infant's blood. Samples from infants are usually obtained by the heelstick procedure when only a small quantity of blood is needed. The baby's foot is wrapped in a warm cloth for five minutes to bring blood to the surface and help it to flow more easily. The foot is then sterilized with an alcohol swab and a lancet is used to puncture the baby's heel on one side, avoiding the center of the heel to prevent inflammation of the bone. The blood sample is drawn in tiny capillary tubes, properly labeled, and taken to the laboratory for testing. In rare instances, a phlebotomist is not able to draw sufficient blood from a heel puncture, and a physician may draw venous blood from a femoral vein in the groin area or another vein larger than veins in an infant's arms.
Since the TORCH test is a screening or first-level test, the pediatrician may order tests of other body fluids or tissues to confirm the diagnosis of a specific infection. In suspected cases of toxoplasmosis, rubella, or syphilis, cerebrospinal fluid may be obtained from the infant by spinal tap in order to confirm the diagnosis. A diagnosis of CMV is usually confirmed by culturing the virus in a sample of the infant's urine. In HSV infections, tissue culture is the best method to confirm the diagnosis.
Sunday, July 27, 2008
TORCH Information, Cytomegalovirus
Cytomegalovirus (CMV)
Cytomegalovirus belongs to the herpesvirus group of infections. It can be transmitted through body secretions, as well as by sexual contact; some newborns acquire CMV through the mother's breast milk. In adults, it produces symptoms resembling those of mononucleosis. About 1 to 2.2 percent of newborns in the United States are infected with CMV. Of this group, 10 percent have measurable symptoms. The mortality rate for these symptomatic newborns is 20 to 30 percent. Surviving infants with CMV may suffer from hearing problems (15%) or mental retardation (30%). Newborns who acquire CMV during the birth process or shortly after birth may develop pneumonia, hepatitis, or various blood disorders.
Cytomegalovirus belongs to the herpesvirus group of infections. It can be transmitted through body secretions, as well as by sexual contact; some newborns acquire CMV through the mother's breast milk. In adults, it produces symptoms resembling those of mononucleosis. About 1 to 2.2 percent of newborns in the United States are infected with CMV. Of this group, 10 percent have measurable symptoms. The mortality rate for these symptomatic newborns is 20 to 30 percent. Surviving infants with CMV may suffer from hearing problems (15%) or mental retardation (30%). Newborns who acquire CMV during the birth process or shortly after birth may develop pneumonia, hepatitis, or various blood disorders.
TORCH information, Rubella
Rubella
Rubella is a virus that has a seasonal pattern, with epidemics most likely in the spring. Between 0.1 to 2 percent of newborns are infected with rubella. The rate of fetal infection varies according to the timing of the mother's infection during pregnancy. Birth defects, however, are most likely (85%) in infants infected during the first eight weeks of pregnancy. Infants born with rubella may already show signs of heart disease, retarded growth, hearing loss, blood disorders, vision problems, or pneumonia. They may also develop problems later in childhood, including autism, hearing loss, brain syndromes, immune system disorders, or thyroid disease.
Rubella is a virus that has a seasonal pattern, with epidemics most likely in the spring. Between 0.1 to 2 percent of newborns are infected with rubella. The rate of fetal infection varies according to the timing of the mother's infection during pregnancy. Birth defects, however, are most likely (85%) in infants infected during the first eight weeks of pregnancy. Infants born with rubella may already show signs of heart disease, retarded growth, hearing loss, blood disorders, vision problems, or pneumonia. They may also develop problems later in childhood, including autism, hearing loss, brain syndromes, immune system disorders, or thyroid disease.
TORCH Information, Other Viruses
Other Viruses (Syphilis)
Syphilis is caused by the spiral- or coil-shaped bacteria (spirochete), Treponema pallidum. It is transmitted among adults through sexual intercourse. About 2 to 5 percent of children born to mothers diagnosed with syphilis have the disease at birth. Syphilis was added to the TORCH panel because of an increase in reported cases after 1990. Syphilis can cause early delivery, miscarriage, and is a potentially life-threatening infection for an affected fetus, often resulting in stillbirth. The mortality rate in infants infected with syphilis is about 54 percent.
Syphilis is caused by the spiral- or coil-shaped bacteria (spirochete), Treponema pallidum. It is transmitted among adults through sexual intercourse. About 2 to 5 percent of children born to mothers diagnosed with syphilis have the disease at birth. Syphilis was added to the TORCH panel because of an increase in reported cases after 1990. Syphilis can cause early delivery, miscarriage, and is a potentially life-threatening infection for an affected fetus, often resulting in stillbirth. The mortality rate in infants infected with syphilis is about 54 percent.
TORCH Information, TOXO
Toxoplasmosis
Toxoplasmosis is caused by Toxoplasma gondii, a parasite that can be acquired by the mother from handling cat feces, drinking unpasteurized milk, or eating contaminated meat. The infection is carried to the infant through the mother's placenta and can cause impairment of the infant's eyes (opthalmic impairment) and central nervous system (neurological dysfunction). The organism can invade brain or muscle tissue and form cysts. Infection acquired by the mother later in pregnancy usually decreases the likelihood of infection in the infant at birth although eye problems may occur in adolescence. Toxoplasmosis early in pregnancy is more likely to cause miscarriage or serious birth defects. The incidence of toxoplasmosis in newborns is one in 1,000 live births.
Toxoplasmosis is caused by Toxoplasma gondii, a parasite that can be acquired by the mother from handling cat feces, drinking unpasteurized milk, or eating contaminated meat. The infection is carried to the infant through the mother's placenta and can cause impairment of the infant's eyes (opthalmic impairment) and central nervous system (neurological dysfunction). The organism can invade brain or muscle tissue and form cysts. Infection acquired by the mother later in pregnancy usually decreases the likelihood of infection in the infant at birth although eye problems may occur in adolescence. Toxoplasmosis early in pregnancy is more likely to cause miscarriage or serious birth defects. The incidence of toxoplasmosis in newborns is one in 1,000 live births.
Torch Test
The TORCH test, which is sometimes called the TORCH panel, belongs to a category of blood tests called infectious-disease antibody titer tests. This type of blood test measures the presence of antibodies (protein molecules produced by the human immune system in response to a specific disease agent) and their level of concentration in the blood. The name of the test comes from the initial letters of the five disease categories. The TORCH test measures the levels of an infant's antibodies against five groups of chronic infections: toxoplasmosis, other infections, rubella, cytomegalovirus (CMV), and herpes simplex virus (HSV). The "other infections" usually include syphilis, hepatitis B, coxsackie virus, Epstein-Barr virus, varicella-zoster virus, and human parvovirus.
Since the TORCH test is a screening or first-level test, the pediatrician may order tests of other body fluids or tissues to confirm the diagnosis of a specific infection. In the case of toxoplasmosis, rubella, and syphilis, cerebrospinal fluid may be obtained from the infant through a spinal tap in order to confirm the diagnosis. In the case of CMV, the diagnosis is confirmed by culturing the virus in a sample of the infant's urine. In HSV infections, tissue culture is the best method to confirm the diagnosis.
Description
The TORCH panel requires a sample of the infant's blood. Samples from infants are usually obtained by the heelstick procedure when only a small quantity of blood is needed. The baby's foot is wrapped in a warm cloth for five minutes, to make the blood flow more easily. The foot is then wiped with an alcohol swab and a lancet is used to stick the baby's heel on one side. It is important to avoid the center of the heel, in order to prevent an inflammation of the bone.
Pregnancy Symptoms, Signs and Symptoms of Being Pregnant
EARLY PREGNANCY SYMPTOMS
Although a lot of women experience pregnancy symptoms, and find signs of being pregnant, other's don't "feel" pregnant. Certain signs and symptoms of being pregnant can be confused with other illnesses. The following list are some telltale symptoms of pregnancy. Morning sickness is one of the most common signs of being pregnant, but you also might be one of the lucky ones who never experience this pregnancy symptom. Missing a period is another sign and symptom of being pregnant. We'll go into greater detail below, and you can read below.
MISSING A PERIOD
One of the most common signs and symptoms of being pregnant, missing a period can also be caused by other reasons. Although missing a period is one of the most common of the pregnancy symptoms, stress, illness, weight fluctuations or coming off the oral contraceptive pill can also be the cause of this. Irregular periods are a common symptom of polycystic ovary syndrome, a condition in which periods can occur several months apart. If you still feel like you are experiencing other pregnancy symptoms, continue reading the other signs of being pregnant.
TENDERNESS OF THE BREAST
Another sign and symptom of pregnancy is the changing of size and feel of your breast. As early as a few days after conception, this pregnancy symptom may occur. Your breast is beginning to enlarge, as it gets ready for breastfeeding. Many women claim that their breasts are very sensitive and that they experience a very sharp, tingling sensation as well. Being one of the signs and symptoms of being pregnant, the tenderness of the breast often disappears a few weeks later.
NAUSEA AND VOMITING
Considered another one of the classic sign and symptoms of being pregnant, nausea and vomiting, (aka morning sickness) has become one of the most feared of all pregnancy symptoms. Feeling sick is a common complaint and is experienced by most women from weeks 5 to 6 of their pregnancy. However, morning sickness can also be felt as early as two weeks after conception. Morning sickness can occur at any time of the day, and can vary from an occasional faint sensation to overwhelming vomiting and nausea. By and large, morning sickness is one of the pregnancy symptoms that tends to disappear towards the end of the first trimester.
TIREDNESS
Many women experience fatigue as one of their pregnancy symptoms. Although this might be a sign of being pregnant, it can also indicate other things as well.
DARKENING OF THE AREOLA
Being one of the first physical symptoms of pregnancy, the darkening of the areola can occur throughout your entire pregnancy. If you notice the darkening of the areola, this could be considered one of the signs and symptoms of being pregnant.
FREQUENT URINATION
If you experience that you are urinating more frequently, this might be another of the pregnancy symptoms that confirm that you are pregnant. As early as two weeks after conception, you might find yourself experience this pregnancy symptom. The pressure of the literally reducing size of your bladder is the cause of this. Your uterus beings to rise up into the abdomen, and this annoying pregnancy symptom is the result. Rising levels of the pregnancy hormone progesterone stimulate the bladder muscles, so that it feels full, even though you might not need to urinate. Of all of the pregnancy symptoms, and signs of being pregnant, women sometimes find this to be the most annoying.
CHANGES IN TASTE AND SMELL
Don't be surprised if you experience this pregnancy sign and symptom. Many women claim that certain foods make them feel queasy - while others experience a craving for other foods. Another sign of this pregnancy symptom, is a strange metallic taste.
CONSTIPATION
Another of the annoying signs and symptoms of being pregnant, constipation occurs.
CONFIRMING YOUR PREGNANCY
Two weeks after conception, your baby is no bigger than a pinhead, comprised of a few balls of cells. As it begins to develop in the lining of the uterus, the placenta begins to form and produce necessary pregnancy hormones. Below are some ways to confirm that the pregnancy symptoms and signs of being pregnant that you have noticed are accurate, and that you will be having a baby.
HOME PREGNANCY TESTS
Being very accurate, these tests can be purchased at a local drugstore, and can confirm pregnancy by detecting the level of HCG in your urine. Your health care provider may rely on this test, and may only repeating testing if complications arise. If you receive a positive result, you may want to make an appointment with your doctor so that they can confirm you are pregnant and begin follow-up.
OFFICE URINE TEST
Similar to that of a home pregnancy test, and office urine test confirms pregnancy by also detecting the level of HCG in your urine. Being nearly 100% accurate, this test does not require you to urinate first thing in the morning. This type of test also can determine that the signs and symptoms of being pregnant hold true, and that your pregnancy symptoms are right.
PREGNANCY BLOOD TEST
In order to assist dating your pregnancy, your healthcare provider may also perform a pregnancy blood test. This particular pregnancy test can give you a positive or negative result, and once again detects the level of HCG. This time, it detects that level in your blood, and depending on your pregnancy symptoms, helps them determine what kind of care to give you. Pregnancy blood tests are useful if there are any concerns about miscarriage, or if there are indications that an unusual pregnancy is occurring.
INTERNAL EXAM
Four to six weeks after conception, your doctor can receive indefinite proof by examining you internally. Certain signs like the thickening of vaginal tissues and the softening of your uterus will confirm that the pregnancy symptoms are right on!
Although a lot of women experience pregnancy symptoms, and find signs of being pregnant, other's don't "feel" pregnant. Certain signs and symptoms of being pregnant can be confused with other illnesses. The following list are some telltale symptoms of pregnancy. Morning sickness is one of the most common signs of being pregnant, but you also might be one of the lucky ones who never experience this pregnancy symptom. Missing a period is another sign and symptom of being pregnant. We'll go into greater detail below, and you can read below.
MISSING A PERIOD
One of the most common signs and symptoms of being pregnant, missing a period can also be caused by other reasons. Although missing a period is one of the most common of the pregnancy symptoms, stress, illness, weight fluctuations or coming off the oral contraceptive pill can also be the cause of this. Irregular periods are a common symptom of polycystic ovary syndrome, a condition in which periods can occur several months apart. If you still feel like you are experiencing other pregnancy symptoms, continue reading the other signs of being pregnant.
TENDERNESS OF THE BREAST
Another sign and symptom of pregnancy is the changing of size and feel of your breast. As early as a few days after conception, this pregnancy symptom may occur. Your breast is beginning to enlarge, as it gets ready for breastfeeding. Many women claim that their breasts are very sensitive and that they experience a very sharp, tingling sensation as well. Being one of the signs and symptoms of being pregnant, the tenderness of the breast often disappears a few weeks later.
NAUSEA AND VOMITING
Considered another one of the classic sign and symptoms of being pregnant, nausea and vomiting, (aka morning sickness) has become one of the most feared of all pregnancy symptoms. Feeling sick is a common complaint and is experienced by most women from weeks 5 to 6 of their pregnancy. However, morning sickness can also be felt as early as two weeks after conception. Morning sickness can occur at any time of the day, and can vary from an occasional faint sensation to overwhelming vomiting and nausea. By and large, morning sickness is one of the pregnancy symptoms that tends to disappear towards the end of the first trimester.
TIREDNESS
Many women experience fatigue as one of their pregnancy symptoms. Although this might be a sign of being pregnant, it can also indicate other things as well.
DARKENING OF THE AREOLA
Being one of the first physical symptoms of pregnancy, the darkening of the areola can occur throughout your entire pregnancy. If you notice the darkening of the areola, this could be considered one of the signs and symptoms of being pregnant.
FREQUENT URINATION
If you experience that you are urinating more frequently, this might be another of the pregnancy symptoms that confirm that you are pregnant. As early as two weeks after conception, you might find yourself experience this pregnancy symptom. The pressure of the literally reducing size of your bladder is the cause of this. Your uterus beings to rise up into the abdomen, and this annoying pregnancy symptom is the result. Rising levels of the pregnancy hormone progesterone stimulate the bladder muscles, so that it feels full, even though you might not need to urinate. Of all of the pregnancy symptoms, and signs of being pregnant, women sometimes find this to be the most annoying.
CHANGES IN TASTE AND SMELL
Don't be surprised if you experience this pregnancy sign and symptom. Many women claim that certain foods make them feel queasy - while others experience a craving for other foods. Another sign of this pregnancy symptom, is a strange metallic taste.
CONSTIPATION
Another of the annoying signs and symptoms of being pregnant, constipation occurs.
CONFIRMING YOUR PREGNANCY
Two weeks after conception, your baby is no bigger than a pinhead, comprised of a few balls of cells. As it begins to develop in the lining of the uterus, the placenta begins to form and produce necessary pregnancy hormones. Below are some ways to confirm that the pregnancy symptoms and signs of being pregnant that you have noticed are accurate, and that you will be having a baby.
HOME PREGNANCY TESTS
Being very accurate, these tests can be purchased at a local drugstore, and can confirm pregnancy by detecting the level of HCG in your urine. Your health care provider may rely on this test, and may only repeating testing if complications arise. If you receive a positive result, you may want to make an appointment with your doctor so that they can confirm you are pregnant and begin follow-up.
OFFICE URINE TEST
Similar to that of a home pregnancy test, and office urine test confirms pregnancy by also detecting the level of HCG in your urine. Being nearly 100% accurate, this test does not require you to urinate first thing in the morning. This type of test also can determine that the signs and symptoms of being pregnant hold true, and that your pregnancy symptoms are right.
PREGNANCY BLOOD TEST
In order to assist dating your pregnancy, your healthcare provider may also perform a pregnancy blood test. This particular pregnancy test can give you a positive or negative result, and once again detects the level of HCG. This time, it detects that level in your blood, and depending on your pregnancy symptoms, helps them determine what kind of care to give you. Pregnancy blood tests are useful if there are any concerns about miscarriage, or if there are indications that an unusual pregnancy is occurring.
INTERNAL EXAM
Four to six weeks after conception, your doctor can receive indefinite proof by examining you internally. Certain signs like the thickening of vaginal tissues and the softening of your uterus will confirm that the pregnancy symptoms are right on!
Subscribe to:
Posts (Atom)
