Reading Test Results TORCH

A colleague (25) was 14 weeks pregnant. During pregnancy 11 weeks, he encouraged the doctor to undergo tests TORCH infections (toxoplasmosis, other infections, rubella, cytomegalovirus (CMV), and herpes simplex virus (HSV)). A week later, the results came back: to toxoplasmosis and rubella IgG positive, while IgM negative. The results of the investigation made him panic and worry about the condition of her fetus, although he was not sure what the difference IgG and IgM. Said the doctor who handles her pregnancy, this fellow does not need too worry as to toxoplasmosis and rubella IgG positive can still be treated with antibiotics. True?

Most cases of toxoplasmosis infection show no clinical symptoms. The only way to determine whether a mother is infected or not is to check blood serum that would indicate presence or absence of parasite called Toxoplasma gondii. Basically, the body will react to any germs that enter and cause infection by forming a specific defense system.

When first infected (primary infection), the human body will form a compound protein IgM (immunoglobulin M) in reaction to the entry of aliens into the body. Compounds of this protein in a relatively short time so the body is formed directly exposed to infection. IgM antibodies will appear in the first week of infection, reaching a peak on one month, then decreased. In some individuals, IgM may remain detectable several years after primary infection. But slowly, this IgM will disappear within 1-24 months later and could arise again if the relevant re-infected.

Depending on the conditions Approximately 4 weeks after the primary infection will be formed also IgG (Immunoglobulin G), which is a repellent or immune substances. IgG is also a protein with large molecular weight. The presence of IgG indicates that the body has been established immunity. So, if the titer / positive number means the body has established immunity against the organism causing the infection. IgG Theoretically this will settle in the body. Only, the levels can go up or down depending on one's health condition. However, in most cases, IgG and IgM rising settled.

IgG and IgM positive indicate a primary infection. This needs treatment and evaluation, both the mother and baby. If IgG positive IgM negative while indicating a recent infection. If the re-examination of the results of IgM and then becomes negative, it means that the detected IgM initially non-specific.

IgG antibodies appear several weeks after IgM response will reach a maximum of 6 months later. The high can last for several years, but finally there is a decrease little by little, generate low and stable levels that may last a lifetime. Thus, mothers who were infected with toxoplasmosis in the past, his IgG titer is never zero or negative.

Allegations against TORCH infections usually are proven through blood tests to measure titer IgG, IgM, or both at once. If IgM can be detected about a week after the acute infection and persist for several weeks or months, IgG antibodies may not appear until several weeks later after the number of IgM increased.

If suspected of being infected, but in fact IgM negative, then the laboratory should be repeated 4 weeks from the first laboratory examination. It is important to ensure there is infection or not. When the re-examination of IgM remained negative, but IgG titers showed increased 4 times, the possibility of being infected is concerned. The occurrence of change in IgM titer from negative to positive, the possibility of re-infected in question middle.

Reexamination The numbers are legible on the results of laboratory examination of blood serum, whether positive or negative, is found only limited to the infectious diseases that can tertitrasi, namely due to TORCH infections. However, although the figures are obtained, the certainty of this infection remains to be proven by further investigation, such as bacterial culture and examination of amniotic fluid. Unfortunately, in Indonesia can not be done so that the diagnosis of viral culture examination of TORCH infection based solely on laboratory results are not necessarily 100 percent true. Why is that?

Therefore, the accuracy of the figures themselves once again terpulang on inspection machines used in the laboratory. That's why doctors often advise patients to do a re-examination to the laboratory examination is different because it is very likely in a laboratory different from the results in other laboratories. The difference itself can be because of the engine, can also be due to a decrease or increase in titer of IgG and IgM according to the current condition of the patient.

When the re-examination 4-6 weeks later IgG did not increase significantly or have no IgM positive value, you can draw a sigh of relief because it means you do not need to receive treatment. It would be better if re-examination was followed by IgG aviditas examination to determine whether a fetus is also infected or not. Aviditas low IgG indicates recent infection, while high IgG aviditas a sign of past immunity.

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Miscarriage, Not Cuts Toxoplasma

Miscarriage or abortion can be caused by many things. The pregnant women are usually overshadowed by fear of the risk of miscarriage due to Toxoplasma infection. In fact, the study did not find any cases of infection in cases of miscarriage.

Based on when they occur can be classified into miscarriage miscarriage preembrionik (occurring under the age of 6 weeks gestation), embryonic miscarriage (at 6-8 weeks gestation), miscarried fetuses (occurred at 8-12 weeks gestation) and miscarried fetuses (occurring at 12-24 weeks gestation).

According dr.Kanadi Sumpapraja, Sp.OG, MSc, from the Clinic Yasmin RSCM, Jakarta, women who experience miscarriage should be reported to the physician the type or category of miscarriage.

"Patients can be informed of miscarriage in weeks of how much, how the condition of the placenta, and so on. This information will guide the doctors to investigate the causes of miscarriage," he explained.

Miscarriage preembionik and many associated with the incidence of embryonic chromosomal abnormality, hormonal disorders, disorders of the endometrium and immunological factors. While the fetus miscarried early and advanced many disorders associated with antiphospholipid syndrome and trombofilia (gore syndrome).

Basically, there are three basic investigation in the case of miscarriage, ie, chromosomal abnormalities, anatomic abnormalities, and abnormalities of blood clotting.

"The case of infection, such as Toxoplasma, it is not found in cases of recurrent miscarriage, so not recommended for investigation," he said.

Added Kanadi, research conducted by organizations in the world of obstetrics and gynecology also found no direct relationship TORCH infections (Toxoplasma, Rubella, Cytomegalovirus, and Herpes Simplex Virus) in miscarriage.

An estimated 7-25 percent of patients with recurrent pregnancy loss caused by the formation of blood clots that block blood flow to the placenta. To overcome this, the doctor will give injections of heparin to prevent blood clots.

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5 Ways to Prevent Spread of Toxoplasma

Toxoplasma is an infectious disease found in animals on the farm or domestic animals. Merupakaan cat carrier (carrier) and can transmit the disease to humans through the feces, especially when it is dry and inhaled by humans.

Although cats can spread the disease, they are not the main source of human infection. Human toxoplasmosis is more likely to experience when eating raw or undercooked meats or not washing hands thoroughly after handling meat. Cats can also suffer from toxoplasmosis from raw meat is consumed or prey on other animals, like rats.
Cats that prey animals have the possibility of having exposure or infection. In many cases, cats will not show signs of infection. However, if the cat has loss of appetite, fever, and lethargy, it's a sign that he has an infection disease.

Humans are exposed to Toxoplasma will experience mild flu-like symptoms. The problem will be more serious in women who are pregnant or in people who have problems with their immune. The fetus in women infected with Toxoplasma will be deformed at birth.

You can prevent the spread of Toxoplasma by doing the following simple way:

1. People who are not pregnant women or who have problems with the immune animal cages should be cleaned every day. Cleaning every day is very important because the feces of infected cats can transmit after 36-48 hours.

2. Use rubber gloves or disposable when cleaning the cage. After that, wash your hands thoroughly using soap.

3. We recommend that you provide in the form of dry cat food, canned, or cooked evenly. Keep them did not seek its own prey.

4. Cook meat thoroughly and evenly. Wash your hands and other equipment in contact with raw meat, such as cutting boards, knives, and the washing bath.

5. Use gloves when gardening. You do not know where cat feces strewn plain. After that, wash your hands.

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Great Head pain due to Toxoplasma

My sister is 21 years old and still studying at a private university. He majored in economics. This morning when going to college she experienced severe headache. Actually, since three days earlier he had complained of pain, but still forced myself to go to college. This time, severe head pain accompanied by vomiting several times.

We took him to the hospital. My sister treated and immediately subjected to several examinations, including MRI examination that expensive. The conclusion was that my brother had Toxoplasma infection in his brain.

The doctor asked us to talk and ask my brother habits, including whether he ever used injection drugs. Indeed, my younger brother about six years ago using injection drugs, but we already took him to the doctor and thankfully these habits to halt five years ago. He can go back to school and a history of drug use has become the past.

According to the doctor, my brother was infected with hepatitis C and HIV. Immune already low, only 82, but normally more than 400. As a result, my younger brother suffered two opportunistic infections, namely tuberculosis and Toxoplasma in the brain. We were really surprised by the explanation the doctor. Infection of the brain is certainly a dangerous disease and its treatment is difficult.

Our whole family will give support to my sister to be cured of lung and brain infection. I know for hepatitis C drug is expensive and a cure for HIV will be able to help the government. My question is whether my brother to recover his health after getting an infection in the brain? Is he going to defect, how the capacity to think? Right now though severe headache, consciousness is still good. Thanks for the explanation physician

J in B



HIV infection in our country are often obtained. It is estimated there are about 300,000 people infected in Indonesia. If the body's immune (CD4) decreased sharply, then there is the risk of infection who were on the so-called opportunistic infections. Opportunistic infections in people with HIV / AIDS (HIV) are often in Indonesia is tuberculosis. However, at Cipto Mangunkusumo Hospital of opportunistic infections in the form of an infection of the brain are fairly common.

At the hospital there were about 400 brain infection, including Toxoplasma. The Indonesian population is very familiar with Toxoplasma. Generally in life, we have been exposed to Toxoplasma, usually through contaminated food (usually meat) that contain Toxoplasma. After the exposure we might get sick of a fever and swollen lymph nodes neck area.

If the infection was cured, the parasite Toxoplasma still exist in our bodies. At the time of severe immune decline in HIV infection for example, it will experience a reactivation of Toxoplasma. Reactivation occurs frequently in the form of Toxoplasma infection of the brain. Symptoms of toxoplasmosis of the brain is a progressive form of headache that can be accompanied by vomiting. The diagnosis will be more sharp when done on brain imaging examination, either by CT scan or MRI. But unfortunately the two examinations are expensive, so if not possible, then the doctor should be able to rely on clinical skills.

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TORCH Infections Cause Defects Fetus

nfeksi TORCH is a disorder of pregnancy that could harm the fetus. If these infections early in pregnancy, the risk of transmission from mother to fetus can be reduced so that defects can be prevented.

TORCH (toxoplasmosis, rubella, cytomegalovirus / CMV, and herpes simplex) refers to the group of infections that can be passed from pregnant mothers to their babies. The infection is usually asymptomatic, the only way to find out is by testing blood serum.

Immunology expert Dr.Liliane Grangeot-Keros from Paris says, TORCH infection can cause miscarriages and 5-10 percent of congenital malformations in the fetus that include hearing loss, mental retardation and blindness.

"Most of the defects could be prevented by doing TORCH screening in the first trimester of pregnancy. If the result is negative, the mothers could be given education the importance of maintaining personal hygiene. But if it is positive, doctors can provide treatment to reduce the risk of transmission from mother to fetus," he said in educating the media event 'wary of TORCH in Pregnancy "in Jakarta (02/24/2011).

In Indonesia, than 54,000 pregnancies that infected 70 percent had antibodies to Toxoplasma. Meanwhile, 60 percent of women have antibodies against herpes simplex virus. Nevertheless, 50-85 percent of pregnant women infected with rubella in the first trimester of pregnancy the fetus at high risk for organ defects.

But according to dr.Yuditia Purwosunu Sp.OG (K), TORCH screening is not a recommendation for pregnant women.

"Statistics show that, of 10,000 pregnant women with positive skriningnya TORCH results, only 10 are also positive diagnostic results. Therefore, TORCH screening is disputed its accuracy," he said in the same occasion.

He added, prenatal screening is recommended only for those belonging to high risk groups, such as HIV-infected mothers. "To provide even the standard treatment is a positive diagnostic results," said a doctor from the division department fetomaternal Obgyn FKUI / RSCM Jakarta.

Diagnostic tests carried out by taking a bit of amniotic fluid for examination in the laboratory. The result is much more accurate than with the screening of blood sampling. "If the new positive screening results are advised to conduct diagnostic tests before treatment is given," he said.

Currently, the examination of TORCH is still relatively expensive for most people. However, according to Keros preventive action is far cheaper than curative.

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Know TORCH Infections

TORCH infections (toxoplasmosis, rubella, cytomegalovirus / CMV and herpes simplex) refers to a group of infections that can be passed from pregnant women to their babies. TORCH-infected pregnant women with high risk of transmitting it to her fetus that can cause birth defects.

Allegations against TORCH infections can only be proved by performing blood tests or screening. If the result is positive, or there is active infection your doctor may recommend diagnostic tests in the form of making little amniotic fluid to be examined in the laboratory.

Here are the types of TORCH infections:

1. Toxoplasmosis infection is transmitted by a parasite (protozoan parasite Toxoplasma gondii). The infection is transmitted from animal to human heat-bodied. According dr.Yuditia Purwosunu Sp.OG (K), this parasite into the human body through food. "The source is mainly the meat not cooked or raw vegetables. The hand that also can become contaminated with Toxoplasma transmission media if we are not wash hands before eating," he said.

In the case of primary maternal infection occurs in pregnancy, the parasite can be transmitted from the placenta and cause fetal defects in the form of visual impairment or spontaneous miscarriage, although the percentage is small.

2. Infection with rubella infection is also known as German measles and often suffered by children. Rubella tri experienced in the first half of pregnancy 90 percent of causing blindness, deafness, heart abnormalities, mental retardation, and even miscarriage.

"Pregnant women are advised to not having contact with people who are sick German measles," said Dr.Liliane G. Keros, immunology experts from Paris. To prevent this, women are advised to vaccinate rubella. "Protection reached 100 percent," he added.

3. Cytomegalovirus (CMV) CMV is a herpes virus family. The virus is transmitted through sexual contact or during pregnancy. As a result of these infections can be fatal because it causes birth defects in the fetus. Unfortunately there is no treatment that can prevent infection with this virus.

4. Herpes simplex herpes virus consists of 2 types, namely herpes simplex 1 (HSV-1) and herpes simplex virus 2 (HSV 2). Transmission usually occurs in sexual contact in adults. HSV-1 also can be transmitted through social contacts in childhood. HSV-2 prevalence was higher in HIV-positive group and those who have sex without a condom.

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