Is routine TORCH screening warranted in neonates with lenticulostriate vasculopathy?
BACKGROUND
Congenital infections are associated with a wide spectrum of clinical symptoms, including lenticulostriate vasculopathy (LSV).


OBJECTIVE
To determine the relationship between LSV and congenital infections, as diagnosed by TORCH serology and viral culture for cytomegalovirus (CMV).


METHODS
All neonates with LSV admitted to our neonatal intensive-care unit from 2004 to 2008 were included in the study. Results of maternal and neonatal TORCH testing were evaluated.


RESULTS
During the study period, cranial ultrasound scans were performed in 2,088 neonates. LSV was detected in 80 (4%) neonates. Maternal and/or neonatal serological TORCH tests were performed in 73% (58/80) of cases. None of the mothers or infants (0 of 58) had positive IgM titres for Toxoplasma, rubella, CMV or herpes simplex virus. Additional urine culture for CMV was performed in 38 neonates. None of the infants (0 of 38) had a positive CMV urine culture test.


CONCLUSIONS
Routinely applied efforts to diagnose congenital infections in cases presenting with LSV have a poor yield. Routine TORCH screening in neonates with LSV cases should only be regarded as mandatory once well-designed studies demonstrate a clear diagnostic benefit.
de Jong
E P
EP
Division of Neonatology, Department of Paediatrics, Leiden University Medical Centre, NL-2300 RC Leiden, The Netherlands.
Lopriore
E
E
Vossen
A C T M
AC
Steggerda
S J
SJ
Te Pas
A B
AB
Kroes
A C M
AC
Walther
F J
FJ
D000465:Algorithms; D020144:Basal Ganglia Cerebrovascular Disease / Q000151:congenital / Q000175:diagnosis* / Q000453:epidemiology; D003586:Cytomegalovirus Infections / Q000151:congenital / Q000175:diagnosis / Q000453:epidemiology; D003955:Diagnostic Tests, Routine / Q000379:methods / Q000706:statistics & numerical data; D004453:Echoencephalography / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D008297:Male; D008828:Microbiological Techniques / Q000379:methods / Q000706:statistics & numerical data; D009035:Mothers / Q000706:statistics & numerical data; D015997:Neonatal Screening / Q000379:methods / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D012698:Serologic Tests / Q000379:methods / Q000706:statistics & numerical data