Table of contents:
- What is toxoplasmosis
- Ways of infection with toxoplasmosis
- Diagnosis of toxoplasmosis
- Congenital toxoplasmosis
- Acute toxoplasmosis
- Cerebral toxoplasmosis (toxoplasmosis of the brain)
- Acquired toxoplasmosis
- Toxoplasmosis during pregnancy
- Why is toxoplasmosis dangerous for a child
- Diagnosis of toxoplasmosis in pregnant women and newborns
- Toxoplasmosis - treatment
- Prevention of toxoplasmosis
Video: Toxoplasmosis - Treatment With Medicines And Folk Remedies
2023 Author: Riley Dean | [email protected]. Last modified: 2023-05-24 12:07
Toxoplasmosis - treatment for the acute form of the disease predetermines the use of chemotherapy drugs. Disease in any form is very dangerous. The peculiarity of many parasitic diseases is that they often manifest themselves in any way, slowly undermining your health. Toxoplasma is one such parasite. Toxoplasma poses the greatest danger to pregnant women and newborn babies.
The content of the article:
- 1 What is toxoplasmosis
- 2 Ways of infection with toxoplasmosis
- 3 Diagnosis of toxoplasmosis
- 4 Congenital toxoplasmosis
- 5 Acute toxoplasmosis
- 6 Cerebral toxoplasmosis (toxoplasmosis of the brain)
- 7 Acquired toxoplasmosis
- 8 Toxoplasmosis during pregnancy
- 9 Why is toxoplasmosis dangerous for a child
- 10 Diagnosis of toxoplasmosis in pregnant women and newborns
- 11 Toxoplasmosis - treatment
- 12 Prevention of toxoplasmosis
What is toxoplasmosis
Toxoplasmosis is an infectious disease caused by the protozoan parasite Toxoplasma gondii and is characterized mainly by a chronic course, enlarged lymph nodes, liver, spleen, muscle damage, nervous system, heart and eyes.
Toxoplasmosis is very common. According to some data, in the United States by the age of 50, about 67% of people are infected, in the CIS countries - about 30%. The disease belongs to zoonoses - infections, the main hosts and distributors of which are animals, in our case, representatives of the feline family, or rather, domestic cats.
It is in the cat's body that the pathogen goes through a full cycle of its development with the formation of a sexually mature cell. Other animals and humans are only intermediate hosts of the parasite.
Cats become infected with Toxoplasma by eating sick mice and birds. Once in the digestive tract, the pathogen invades the epithelial cells of the small intestine and begins to multiply. Toxoplasma is excreted in huge quantities with feces, and the animal becomes infectious.
Ways of infection with toxoplasmosis
Once in the external environment, in favorable conditions, the parasite can persist for several months, posing a danger to humans and mammals. Toxoplasmas, dressed in dense thick shells, are protected from many chemicals, including disinfecting solutions, and only drying, heat treatment and freezing can neutralize the microbe.
Human infection occurs when eating meat products and eggs that have not undergone sufficient heat treatment.
Toxoplasmosis - treatment. The possibility of infection is not excluded when the pathogen gets on the mucous membranes and damaged skin, in a transmissible and other way. Intrauterine infection is also observed. In the human body, Toxoplasma multiplies in the intestines, spreads by lymphogenous and hematogenous pathways. The phase of lymphogenous drift (lymph nodes increase and become inflamed) is replaced by hematogenous dissimination.
The stage of finding the parasite in the blood is short (several days). Getting into the internal organs, Toxoplasma causes inflammation in them. The nervous system, retina, liver, myocardium are especially often affected. In these organs, Toxoplasma are intracellular and extracellular. Clusters of parasites are called pseudocysts.
Toxoplasmas are able to form cysts in tissues, causing a state of latent infection. The activation of the parasite occurs under conditions unfavorable for the macroorganism and a decrease in its immunological reactivity.
Toxoplasmosis - treatment. In the pathogenesis of toxoplasmotic lesions of the nervous system, focal inflammation (necrotizing encephalitis), dyscirculatory disorders associated with vasculitis, obstruction of the cerebrospinal fluid, leading to hydro- and microcephaly are important.
Morphological manifestations of toxoplasmosis of the brain in adults are diverse. On microscopic examination, miliary granulomas scattered throughout the brain and spinal cord are most characteristic, consisting of large epithelioid cells, lymphocytes, monocytes, and sometimes eosinophils.
Granulomas contain numerous parasites, surrounded by a zone of edema with necrotic foci caused by vasculitis. Calcification of small foci is typical for toxoplasmosis. In the presence of toxoplasma in the subarachnoid space, serous-productive leptomeningitis occurs.
The most gross morphological changes in the nervous system are observed in children. Macroscopic examination reveals expansion of the ventricles with a periventricular zone of necrosis. Scars replacing areas of necrosis, obliteration of the interventricular foramen and the lateral aperture of the IV ventricle are found. Hydrocephalus can be expressed, leading to thinning and deformation of the hemispheric substance.
Most of those infected have no clinical manifestations of the disease. In some patients, sluggish chronic forms are observed and, extremely rarely, acute, with a severe course of the disease. With intrauterine infection in the first months of pregnancy, miscarriage and fetal death often occur.
Toxoplasmosis - treatment. The possibility of intrauterine fetal deformities and the birth of children with developmental defects is not excluded. If the infection occurs late in pregnancy, a child is born with generalized toxoplasmosis.
Diagnosis of toxoplasmosis
Diagnosis of toxoplasmosis is based on the determination of traces of infection in the body (antibodies against toxoplasma), as well as on instrumental research methods (for example, ultrasound, computed tomography, etc.).
A blood test for toxoplasmosis is the determination of antibodies to toxoplasma and is called a serological diagnostic method (serology). The serological method is the main method for diagnosing toxoplasmosis.
To understand the essence of the serological method for diagnosing toxoplasmosis, it is necessary to know how the human body reacts to any infection, including toxoplasmosis: immediately after the parasite enters the human blood, the immune system recognizes it as a foreign substance (antigen) and begins to fight against it.
Toxoplasmosis - treatment. Special cells of the immune system produce substances (antibodies) that are directed against a particular type of parasite. Antibodies, or immunoglobulins (Ig) have specificity strictly to a specific antigen and, recognizing it, immediately bind to it.
Even after the immune system has defeated the infection, antibodies against this infection remain in the body for several years (and sometimes for a lifetime).
IgM appears in the body about 2 weeks after infection with Toxoplasma, their number gradually reaches a peak and then decreases to zero by about 8-10 weeks after infection.
The presence of IgM in the blood indicates that this is an acute infection, that is, a person is currently sick with toxoplasmosis. The detection of IgG in the blood, on the contrary, suggests that the body has met the infection before, but has already defeated it.
If both IgM and IgG were found in the blood, this means that the infection has occurred within the last 12 months. Doctors also take into account such a characteristic of antibodies as a variety.
A type of antibody is the property of an antibody to firmly bind to an antigen (foreign substance). The earlier the body meets the infection, the higher the type of antibodies.
The final interpretation of the toxoplasmosis test can only be made by a physician who is familiar with the patient's medical history and reference values that are used in the laboratory that performed the analysis.
Toxoplasmosis - treatment. A particular danger is the likelihood of intrauterine infection of the fetus. Toxoplasma is able to cross the placenta and cause illness in an unborn child. But this is only possible if the mother becomes infected with toxoplasmosis during pregnancy. If she became infected even before pregnancy, nothing threatens the unborn child.
With congenital toxoplasmosis, organ damage is very significant. So, congenital malformations of the eyeball are possible, up to the development of blindness, underdevelopment of the brain and spinal cord. The severity of fetal damage is closely related to the timing of pregnancy - the younger the fetus, the more severe the disease.
As a result of congenital toxoplasmosis, the fetus either dies as a result of deformities incompatible with life, or is born with symptoms of acute congenital toxoplasmosis - intoxication, fever, jaundice, lesions of the liver, spleen, lymph nodes and central nervous system (encephalomyelitis).
But toxoplasmosis can affect the fetus only once, all subsequent pregnancies will be reliably protected by the antibodies formed in the mother.
Acute toxoplasmosis in adults with no other medical conditions is usually asymptomatic.
However, in rare cases, the following symptoms may appear:
- an increase in the size of the axillary lymph nodes is the most common sign of toxoplasmosis. Enlarged lymph nodes are felt as rounded dense formations in the armpit. There may be an increase in other groups of lymph nodes (cervical, submandibular, inguinal, etc.);
- increase in body temperature up to 38-39 C.;
- weakness, muscle pain;
- an increase in the size of the liver and / or spleen, which is manifested by a dull pain in the right side (in the right hypochondrium);
- often the disease proceeds unnoticed by the patient and goes away on its own without treatment within one to two weeks.
Cerebral toxoplasmosis (toxoplasmosis of the brain)
Toxoplasmosis - treatment. Cerebral toxoplasmosis is a form of toxoplasmosis that occurs with inflammation of the brain.
In persons whose immunity is weakened by AIDS and other diseases, toxoplasma is deposited in the nervous system, leading to the appearance of characteristic symptoms:
- severe weakness, headaches;
- increased body temperature;
- loss of sensitivity in various areas of the body;
- feeling of running "goose bumps" on the body;
- paralysis - the inability to move certain parts of the body;
- coma - complete permanent loss of consciousness.
The incubation period is from 3 to 14 days. Prodromal period with general malaise, muscle and joint pain - usually several weeks, sometimes months. The acute stage of the disease is manifested by an increase in temperature, chills, lymphadenopathy. A generalized maculopapular rash appears that is absent only on the soles, palms, and scalp.
Along with the general signs of an infectious disease, there is a clinical picture of damage to various organs: myocarditis, pneumonia, focal necrotizing nephritis, hepatitis. Damage to the nervous system is manifested by meningitis, encephalitis, meningoencephalitis, encephalomyelitis. Radiculoneuritic and oligosymptomatic forms are rarely observed (the latter can only be detected using serological reactions).
The most typical form of toxoplasmosis is meningoencephalitis, in the clinical picture of which there are cerebral and meningeal symptoms, paresis of the extremities, tonic-clonic seizures, oculomotor (diplopia) and coordination disorders. Sometimes single or multiple toxoplasmotic abscesses develop in the brain.
Toxoplasmosis - treatment. Disorders of consciousness, lethargy, loss of memory and orientation in space are characteristic. In the blood, leukocytosis with a shift of the formula to the left, an increase in ESR are found, in the cerebrospinal fluid - lymphocytic pleocytosis, a moderate increase in protein content.
Allocate acute, chronic and latent forms with the division of the latter into primary-latent, without clinical manifestations, and secondary-latent, arising after an acute form or recurrence of a chronic one.
Toxoplasmosis during pregnancy
Many people have heard about the danger of toxoplasmosis in pregnant women. Hence the advice to throw the cat out of the house, and panic from any scratch. However, not everything is so bad.
The risk to the fetus is only the primary infection of the mother with toxoplasmosis during pregnancy. That is, if you have had it long ago, then it will not have any effect on the fetus. At the same time, even with primary infection, the risk of fetal infection is not 100%. In the first trimester, the risk of infection with a mother's disease is 15-20%, in the second - 30%, in the third - 60%. However, although the risk of infection increases with gestational age, the severity of clinical manifestations decreases.
Toxoplasmosis - treatment. When infected in the first trimester, in most cases, the child has malformations incompatible with life, and when infected at the end of pregnancy, severe clinical symptoms may be absent altogether.
In the event that infection occurs before 24 weeks, termination of pregnancy is recommended. If a woman refuses it, treatment is possible.
After the disease, a person develops immunity, so a repeated meeting with the parasite is not terrible for him. After the initial infection with toxoplasmosis, pregnancy can be planned after six months.
Why is toxoplasmosis dangerous for a child
When the fetus becomes infected in the 1-2 trimester, embryopathy develops (multiple defects, mainly of the central nervous system and eyes), which often leads to its death. If infected at a later date, there may be prematurity, intrauterine growth retardation, the child is born with a clinical picture of sepsis and damage to many organs and systems.
In addition, timely prescribed treatment for a pregnant woman helps to prevent the disease in a child. Examination of immuno-negative pregnant women (when there are no specific antibodies in the blood) is carried out every 2 months.
Toxoplasmosis - treatment. In a woman, a child with toxoplasmosis can be born only once in case of infection that first occurred during pregnancy, which is extremely rare.
When an acute infection is detected, specific treatment is prescribed, but not earlier than within 12 weeks, because most of the drugs used are antibiotics that can cause disturbances in the development and formation of the fetus (i.e., have a teratogenic effect).
In pregnant women with chronic toxoplasmosis or carriers of the pathogen, even with an exacerbation of the disease, infectious agents do not enter the bloodstream, and therefore there is no threat of infection of the fetus.
Diagnosis of toxoplasmosis in pregnant women and newborns
The most severe forms of toxoplasmosis occur in children who are infected from the mother during fetal development. Thus, the most important is the diagnosis of toxoplasmosis during pregnancy.
If IgM and IgG antibodies are found in a pregnant woman's blood, then it is recommended to do a test for a type of IgG. A high IgG variety (usually more than 40%) at 12-14 weeks of gestation practically excludes the possibility of infection during pregnancy (and, accordingly, the likelihood of infection of the fetus).
However, a low variety of antibodies is not yet an indicator of a recent infection - in this case, after 2-3 weeks, the test is repeated and the amount of antibodies has increased (antibody titer).
To find out whether the infection has been transmitted from a pregnant woman to a fetus, amniotic fluid is often analyzed for the presence of Toxoplasma DNA.
Toxoplasmosis - treatment. A diagnostic method called polymerase chain reaction (PCR). If the PCR is negative, the fetus is perfectly healthy. To clarify the diagnosis of toxoplasmosis and determine the extent of the spread of the infection, additional examinations are carried out:
- instrumental diagnostic methods include many methods to identify the manifestations of toxoplasmosis. So, if there are symptoms of damage to the central nervous system (brain), do a computed tomography or magnetic resonance imaging, which can determine the foci of brain inflammation caused by toxoplasma;
- biopsy - taking a piece of tissue infected with toxoplasma is rarely used for examination under a microscope.
Toxoplasmosis - treatment
In acute toxoplasmosis, chemotherapy drugs are used.
Delagil (0.5 g 2 times a day) in combination with sulfonamides (0.5 g 2 times a day) for 10 days. Fansidar is prescribed in the amount of 5 tablets per course: 1 table. after 2 days or in the form of intramuscular injections of 1 ampoule of 2.5 mg once every 2 days in the amount of 5 injections. One or two courses of treatment are carried out.
From antibiotics are prescribed: lincomycin hydrochloride (0.5 g 2 times a day); metacyclin hydrochloride (0.3 g 2 times a day) for 5-7 days in combination with sulfonamides; rovamycin.
Treatment of chronic toxoplasmosis is many times more difficult than acute, since chemotherapy does not have a significant effect. The main place is occupied by hyposensitizing and immunomodulatory therapy. The complex of treatment includes vitamins, desensitizing agents, lidase, cerebrolysin, etc.
There is evidence of the positive effect of levamisole in the treatment of chronic toxoplasmosis. Levamisole is prescribed at 150 mg for 3 consecutive days with breaks of 1 week between cycles, only 2 - 3 cycles.
Prevention of toxoplasmosis
Prevention is most important during pregnancy, and for those women who have never met with Toxoplasma before and do not have immunity to it:
- when working in the garden, wear gloves so that the soil does not come into contact with your skin. There may be microcracks on the skin, and toxoplasma in the ground. Wash vegetables and fruits thoroughly;
- it is also better to cut raw meat with gloves, at least after that you need to wash your hands. Thoroughly fry or boil the meat, refuse steaks with blood during pregnancy;
- if you have a kitty, entrust the cleaning of her toilet to someone else, otherwise there are traces of old feces on the cat bath;
- you should not kiss your beloved pet, since in case of acute infection of a cat, Toxoplasma can be excreted from it with saliva and nasal discharge;
- cat feces can be tested to determine if it is infected with toxoplasmosis. If your cat turns out to be so clean that she has never encountered toxoplasmosis, then it is necessary to protect her from the disease in the future (at least for the period of your pregnancy): do not feed raw meat, do not allow communication with relatives and do not let her go outside.
Find out more:
- Toxoplasmosis - symptoms and treatment methods for the disease
- Toxoplasmosis in humans: signs, symptoms and treatment
- Symptoms of parasites in the body - 12 clear signs