Definition
TORCH is an acronym for a group of perinatal infections that can cross the placenta and cause congenital infections. Serologic testing (blood tests for antibodies) helps detect exposure or active infection, especially important in pregnancy and immunocompromised patients (like those in oncology).
TORCH stands for:
| Pathogen | Clinical Significance |
|---|---|
| T – Toxoplasma gondii | Parasitic infection; can cause brain and eye damage in fetus. Risk higher with immunosuppression. |
| O – Other (e.g., syphilis, varicella-zoster, parvovirus B19, HIV, hepatitis B) | Grouped due to similar effects; implications vary by pathogen. |
| R – Rubella (German measles) | Can cause severe birth defects if contracted in early pregnancy. |
| C – Cytomegalovirus (CMV) | Most common congenital infection; important in immunosuppressed cancer patients. |
| H – Herpes simplex virus (HSV) | Can cause neonatal herpes and disseminated disease; reactivation risk in immunocompromised. |
Relevance to Oncology Pharmacists:
- Immunosuppressed Patients: Reactivation of CMV, HSV, and Toxoplasma is a risk during chemotherapy or stem cell transplant.
- Screening Pre-Therapy: TORCH testing may be part of workup in women of childbearing age or in transplant candidates.
- Drug Interactions and Prophylaxis:
- Toxoplasma: Prophylaxis with TMP-SMX in certain patients (e.g., post-transplant).
- CMV: Antivirals like valganciclovir are used; watch for myelosuppression.
- HSV: Acyclovir prophylaxis in seropositive patients during neutropenia.
Serologies Interpretation:
- IgM positive → Suggests recent or acute infection.
- IgG positive → Indicates past exposure or immunity.
- IgM & IgG negative → No evidence of exposure or immunity.