Congenital infections, part I: Cytomegalovirus, Toxoplasma, Rubella, and Herpes Simplex

The clinical importance of early diagnosis of congenital neonatal infections and initiation of early therapy was recognized more than half a century ago. As a result, a serology screening panel was established for Toxoplasma gondii, rubella virus, cytomegalovirus, and herpes simplex virus ("TORCH") that is still widely used in many institutions. Although it no longer is possible to diagnose all recognized congenital infections with one panel, the original TORCH diseases continue to be of clinical importance, and advances in medicine and new findings in epidemiology, preventive medicine, developmental biology, and immunology have brought optimistic changes and intriguing insights to the field. We summarize information from recent studies to provide updates about the diagnostic and therapeutic strategies to combat this complex group of pathogens.