How Does Imaging of Congenital Zika Compare with Imaging of Other TORCH Infections?

Abstract

The acronym TORCH is used to refer to congenital infections, such as toxoplasmosis, other infections (such as syphillis, varicella-zoster, and parvovirus B19), cytomegalovirus, and herpes simplex virus. The classic findings in patients with TORCH infections include rash in the mother during pregnancy and ocular findings in the newborn. Zika virus has emerged as an important worldwide congenital infection. It fits well with other congenital TORCH infections since there is a rash in the mother and there are commonly ocular abnormalities in the newborn. TORCH infections are recognized to have neurologic effects, such as ventriculomegaly, intraventricular adhesions, subependymal cysts, intracerebral calcifications, and microcephaly; however, the Zika virus is intensely neurotropic. Thus, it targets neural progenitor cells, leading to a more severe spectrum of central nervous system abnormalities than is typically seen in other TORCH infections, while relatively sparing the other organ systems. In this review, nonspecific findings of congenital infections initially will be described, then individual TORCH infections will be described and compared with the imaging findings associated with congenital Zika virus infection. For the radiologist, awareness of imaging features of common congenital infections may facilitate early diagnosis and may, at times, lead to prompt initiation of therapy. Online supplemental material is available for this article.

Detection of Zika virus in paired urine and amniotic fluid samples from symptomatic and asymptomatic women and their babies during a disease outbreak: association with neurological symptoms in newborns

“…Therefore, the contribution of other viruses to the observed neurological problems cannot be definitely excluded. Macrocephaly has been previously been described in ZIKV-positive neonates (Levine et al 2017;Chimelli et al 2017), and the present study supports this as a possible ZIKVrelated outcome. One of the babies with macrocephaly was from a mother with GDM.…”

Motor function in children with congenital Zika syndrome

“…S1 and S2, online supporting information). Children in whom no neuroimaging abnormalities were found were excluded …”

Imaging of Emerging Infectious Diseases

“…Parenchymal calcifications can also occur, and are typically located at the gray-white matter junction. Non-neurologic US findings are less specific and include echogenic bowel, hepatosplenomegaly with hepatic calcifications, and talipes equinovarus [15,19].…”