TORCH serologies and specific IgM antibody determination in acquired and congenital infections

Except for rubella testing, routine TORCH serology screens in prenatal care are of little use. Individual TORCH tests may, however, be useful based on the clinical presentation and history of the patient. The laboratory test of choice for diagnosing cytomegalovirus (CMV) and herpes simplex virus (HSV) infections is culture isolation for the virus. The presence for specific IgM antibodies in neonates is diagnostic of congenital infection. In adults, IgM antibody results should be interpreted along with the clinical findings and history of the patient. IgM antibodies may persist for months and even years and may be detected during reactivation of latent virus infections. Serum fractionation should always be performed in IgM antibody testing to avoid false positive results owing to rheumatoid factors and false negative results owing to competing levels of specific IgG antibodies. With a single serum specimen, specific IgM antibody detection may be helpful in differentiating between a recent versus past infection.