Toxoplasmosis in humans: ways of infection, symptoms, diagnosis, treatment and prevention. Tests for toxoplasmosis: normal indicators
In most patients, even if there is toxoplasma in the body, there are no clinical signs of the disease, so a mandatory examination for toxoplasmosis is recommended for those who are at risk. This applies not only to pregnant women, but also to persons who:
- eat under-processed meat;
- work on cattle farms, in zoos, in veterinary clinics;
- have had a blood transfusion or an organ transplant.
How to detect toxoplasmosis in humans by direct methods?
It is most reliable to detect the virus visually. You can see it with multiple magnification under a microscope, but first you need to take liquid or tissue for examination. For research by PCR, tissues are taken that are obtained as a result of a biopsy, or the patient's biological fluids (blood, saliva). The PCR method isolates the DNA of the causative agent of the disease. However, this method is ineffective in the late stages of the disease or in the latent form, when all microorganisms are localized in the organs.
How to determine toxoplasmosis in humans by serological methods?
One of the most effective ways to recognize toxoplasmosis is a serological method for examining blood serum, when not microorganisms are found in the test material, but antibodies to them, which are formed after infection. Specific immunoglobulins belonging to class M are formed immediately after infection. After about a month, their number becomes peak, and then begins to decline. They are replaced by class G antibodies. Their high titers indicate an acute form of the disease. Immunoglobulins of this group in some patients persist for life, so the resulting immunity will not allow you to become infected again.
Some pathologies make themselves felt very quickly, while others are asymptomatic for a long time. From this article you will learn everything about what toxoplasmosis is, what are the symptoms and treatment of this disease, what are the signs of infection and the causes of the disease.
What is toxoplasmosis
Important! Toxoplasmosis is most severe in patients with a congenital diagnosis, so a woman should think about the future of the child even when planning pregnancy.
Toxoplasma is an infection that can infect not only people, but also animals. The main carriers of this microorganism are domestic cats and other members of the cat family.
Causes of infection
The causative agent of toxoplasmosis can be obtained mainly from domestic animals. From person to person, the disease is extremely rare. Toxoplasma can be found in the saliva, feces or milk of animals. Food, water, and surfaces can become infected. When the pathogen enters the human body, it can circulate through the blood, and can be deposited in various organs.
It is possible to distinguish such ways of infection with toxoplasmosis:
- through the consumption of food contaminated with toxoplasma;
- due to poorly fried meat;
- due to the lack of thorough hygiene after cleaning cat litter;
- through blood transfusion;
- when transplanting organs in which there was an infection;
- from mother to child during pregnancy.
For pregnant women, infection with toxoplasmosis is considered extremely undesirable, since the consequences for the child are detrimental. Infection is dangerous because there is a high risk of spontaneous abortion or intrauterine death of the fetus. If a woman becomes infected in the later stages, the complications do not pose a threat to the life of the child, however, after the birth of the disease, the disease may have an acute course and an unfavorable prognosis.
But can an infant during lactation become infected from the mother through milk? The probability is extremely small. Infection is possible only if Toxoplasma is present in the mother's blood, and there are bleeding cracks or sores on the nipples.
Disease classification
There is a classification of toxoplasmosis, which divides the disease into types depending on the nature of the course and the affected area.
According to the nature of the infection, there are:
- acquired form (during life);
- congenital (infection received from the mother and often leads to fatal consequences).
Acquired toxoplasmosis is of the following varieties:
- acute (sudden onset of the disease with vivid symptoms);
- chronic toxoplasmosis (signs are invisible for a long time, asymptomatic course).
Depending on the affected area, the disease is:
- meningoencephalic (toxoplasmosis of the brain);
- ophthalmic (eye damage with impaired visual acuity);
- lymphonodular (lymph nodes suffer);
- cardiac (with heart pain, shortness of breath and other cardiac symptoms).
Regardless of which organs are affected by toxoplasmosis, the disease should be treated as soon as possible. Without adequate therapy, the infection can cause irreversible changes.
Symptoms of toxoplasmosis
The sooner the patient discovers the first signs of toxoplasmosis, the more effective the treatment will be. Symptoms usually appear after the incubation period is over. When infected with Toxoplasma, it lasts from 3 days to 3 weeks. Symptoms of the disease depend on the form of the disease.
Features of acute toxoplasmosis
The acute stage of toxoplasmosis develops in the case of an acquired form of the disease. The disease begins with problems with the lymph nodes. Although they remain soft to the touch and fused with the rest of the soft tissues, and pain is not felt, they increase in size. The occipital and cervical nodes suffer the most, less often the axillary and inguinal lymph nodes are involved in the pathological process.
Sometimes with toxoplasma, the liver and spleen are exposed to the negative effects of infection. These organs are enlarged. A papular roseolous-like rash may occur on the skin (how it looks can be seen in the photo).
After the virus multiplies in the lymphatic system, the infection enters the bloodstream. After that, any organs where the blood carries the pathogen fall under the damaging effect of Toxoplasma.
The following violations are possible:
- sensitivity change;
- dizziness;
- impaired visual acuity;
- increased intracranial pressure;
- muscle tension at the back of the head;
- nausea and vomiting;
- severe headaches;
- hypertensive crises;
- instability of the emotional state.
With more extensive lesions of the spinal cord, pulling pain along the nerves may appear. Sometimes there are complaints of numbness of the limbs, a decrease in pain sensitivity.
Features of chronic toxoplasmosis
The chronic form of toxoplasmosis is characterized by constant exacerbations. Although the clinical picture is erased, negative symptoms are present almost constantly. A person suffers from such phenomena:
- recurrent headaches of varying intensity;
- general weakness;
- decrease in working capacity;
- increase in body temperature to non-critical levels;
- dizziness;
- sudden change of mood;
- irritability;
- sleep failures;
- deterioration in the quality of memory;
- gradual decrease in visual acuity.
Less commonly, patients report unusual visual disturbances. Before the eyes there is a feeling of fogging, flashes, dots. Sometimes the clarity of the image is so reduced that it cannot even be corrected.
In more severe cases, the prolonged presence of Toxoplasma in the body causes more severe disorders, namely:
Features of congenital toxoplasmosis
Congenital toxoplasmosis occurs in a newborn child, provided that his mother became infected with the infection during the gestation period. When the pathogen enters the body of a woman for up to 24 weeks, the pregnancy is spontaneously terminated. In more rare cases, a baby is born with severe defects, including deafness, jaundice, enlarged liver and spleen. If the infection of the expectant mother occurred at a period of 24 to 40 weeks, dropsy of the brain develops.
Treatment at home is not carried out, and the child is provided with the necessary first aid immediately after birth. After the acute stage of the course of the pathology passes, toxoplasmosis can provoke encephalitis, signs of an unstable psyche, obesity and sexual infantilism.
Diagnostic measures
In order for the doctor to correctly prescribe medications, it is important to accurately diagnose the infection. It is especially important to pass all tests in a timely manner during pregnancy.
Examination of a pregnant woman is carried out immediately after registration. Research may include the following activities:
- skin test with toxoplasmin;
- serological tests to determine the titers of immunoglobulins igG and igM.
If the test for toxoplasmosis igG is positive, then igG antibodies are found in the body. This indicates that the pregnant woman has already had contact with the infection and she has strong immunity.
If the studies gave a negative result, the studies are repeated in the second and third trimester. If during this period antibodies to Toxoplasma appeared in the blood, it means that the woman became infected with the infection already during the bearing of the child. Treatment is carried out after the onset of the second trimester.
In addition to a blood test for toxoplasmosis, the following studies are carried out:
- puncture of the spinal cord;
- skull x-ray;
- toxoplasmin test;
- ultrasound examination of internal organs that have been exposed to infection.
If igM immunoglobulins were detected during the serological examination, this indicates the presence of an acute process. They appear in the blood as early as 2 weeks after infection. As you recover, this indicator decreases, and the level of igG increases, which indicates acquired stable immunity. If there are immunoglobulins of both categories in the blood, then the person has encountered the infection within the last year. Thanks to these two indicators, it is possible to determine the avidity for Toxoplasma.
When diagnosing toxoplasmosis in newborns, the parameters of the norm of immunoglobulins are compared with those of the mother. In the presence of a congenital infectious disease, the indicators in an infant will be 4 times higher than in a woman. If the indicators are identical, the study is repeated after 1-2 weeks. Deciphering the results should be carried out only by a doctor.
Treatment of the disease
A doctor's prescription may include the following groups of medicines:
- sulfonamides;
- antibacterial agents;
- glucocorticoids;
- immunomodulators;
- vitamins;
- antihistamines.
What medications to use, the doctor decides after examining the patient and obtaining all the necessary examination results, most often Rovamycin is prescribed to combat the causative agent of toxoplasmosis. This drug is usually prescribed to adults and patients over 3 years of age, with the exception of the congenital form of the disease.
Although some believe that alternative methods can be effective, their use and neglect of the main treatment can lead to serious consequences and progression of the disease.
Prevention
Prevention consists of the following activities:
- meticulous hygiene and washing of fruits and vegetables;
- high-quality thermal preparation of meat products;
- wash hands after contact with pets;
- always wash your hands before eating.
Women should be especially careful during pregnancy. To make sure that pets are not carriers of the infection, you can take their feces for analysis.
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Toxoplasmosis infection among the population is high: in European countries, the number of infected is from 25 to 50%, in African countries the disease is diagnosed in 90% of the population, in Russia the situation is calmer - infection is diagnosed in no more than 35% of the population. The most dangerous thing is when a future mother or a person with low immunity becomes infected with toxoplasmosis.
Toxoplasmosis during pregnancy can lead to such consequences for the fetus as spontaneous abortion, infection of the unborn child, malformations, stillbirths.
If people with immunodeficiency get sick with an infection, then the disease is extremely difficult, aggravating the course of the underlying pathology.
The disease is caused by Toxoplasma gondii, an organism from the class of protozoa. Humans are most likely to contract toxoplasmosis from infected animals. The causative agent of infection can be contained in their milk, saliva and excrement.
In most cases, people become infected with this infection through food, if they somehow got Toxoplasma gondii.
Rarely known transmissible ways of transmission of toxoplasmosis - through the mucous membranes and skin in violation of their integrity. It is even rarer to get infected through a blood transfusion or after an organ transplant. If toxoplasmosis is diagnosed in pregnant women, then the pathogens easily penetrate the placenta to the fetus, thus, the fetus becomes infected.
If we summarize what routes of infection are, we can pay attention to non-compliance with the rules when cutting and preparing dishes from raw minced meat and meat, direct contact with animals, in particular, caring for them, insufficiently processed fruits and vegetables, work in agriculture directly with the soil and much more.
But whether toxoplasmosis is transmitted from person to person, if we omit the topic of pregnancy, the question is ambiguous, since the domestic and sexual transmission of the infection is excluded. That is, this rarely happens.
Development of toxoplasmosis (life cycle)
In the asexual form, Toxoplasma can be found in the bodies of animals, birds, or humans. They become intermediate carriers of the infection. For some, this fact can cause the development of the disease, while for others it can lead to behavioral changes.
Once in the human body, oocysts are introduced into the enterocytes of the duodenum, then into the mesenteric lymph nodes, provoking the development of an inflammatory process, necrosis, calcifications and granulomas in them. From the primary focus of infection, pathogens enter the systemic circulation and spread throughout the body, lingering in individual organs. The incubation period for toxoplasmosis lasts from 14 to 21 days.
Forms of toxoplasmosis
There are two forms of the disease - congenital and acquired toxoplasmosis.
It is the result of infection of the fetus in the womb. If this happens immediately after conception, the fetus usually does not survive and is spontaneously rejected from the mother's body. In the case of further development, he usually has the most severe organic pathologies of the central nervous system, for example, hydrocephalus, microcephaly, etc.
If infection of the fetus occurs after 12 weeks, congenital toxoplasmosis is diagnosed in newborns. Such children are born with symptoms of a generalized infection and damage to many vital organs. Most anomalies are incompatible with the life of the child, so most of these children die at an early age.
Acquired toxoplasmosis.
It manifests itself in three types - acute, chronic and latent course. They are detailed in the following table.| Forms of acquired toxoplasmosis | Features of the flow |
|---|---|
| ACUTE TOXOPLASMOSIS |
|
| CHRONIC TOXOPLASMOSIS |
|
| LATENT TOXOPLASMOSIS |
|
Congenital toxoplasmosis is more dangerous than acquired.
Symptoms
Signs of toxoplasmosis in humans are not easy to determine. Basically, the disease proceeds under the guise of other pathologies and inflammatory processes. Sometimes the disease from one stage quickly and smoothly passes into another, asymptomatic, thereby complicating the possible diagnosis.
In any case, toxoplasmosis in adults and children proceeds differently in both congenital and acquired forms of the disease. Sometimes the symptoms are reduced to acute symptoms of a cold, less often to oncological pathologies. At the same time, the manifestations of the clinic in the carrier of toxoplasmosis always have different severity. Consider how toxoplasmosis manifests itself depending on the type of disease.
The acute form of toxoplasmosis begins with general intoxication of the body and hyperthermia. In persons who are faced with the disease, signs of lymphadenopathy, an enlarged liver, and a maculo-papular rash begin to appear. Sometimes symptoms of encephalitis, myocarditis and meningitis develop.
Depending on the main syndrome, encephalitic, typhoid-like and mixed forms of pathology are detected. After the acute stage subsides, the disease passes into a chronic process.
Chronic toxoplasmosis
The chronic form of toxoplasmosis is also characterized by various clinical manifestations. With this form of the disease, subfebrile condition is noted for several months and even years. As well as chronic intoxication of the body, which eventually leads to damage to internal organs and systems.
The disease causes damage to the following systems, which we will consider in the table.
Latent toxoplasmosis
In this case, the disease is asymptomatic. A person is its carrier, but is not dangerous to others.
Cerebral toxoplasmosis (brain)
Nowadays, cerebral toxoplasmosis or cerebral toxoplasmosis is a rare condition that is more common in people with immunodeficiency, such as those with HIV infection. This form of the disease is considered life-threatening, since its treatment will be quite difficult, and even despite the measures taken, after recovery, a person will forever have stable neurological disorders.
Many after this form of toxoplasmosis never return to normal life, lose their ability to work and become disabled.
Cerebral toxoplasmosis occurs with symptoms of brain damage, the severity of which depends on the area and form of the pathological process.
The congenital form of cerebral toxoplasmosis in children is characterized by a more severe course compared to adults. Asymptomatic cases of this pathology are rare.
Toxoplasmosis of the brain occurs in acute and chronic form, and is manifested by the following symptoms noted in the table.
Treatment is selected by a specialist based on the results of the examination, which should reveal the form of the disease and the degree of damage to the brain and other organs. After the diagnosis is made and the cerebral form of toxoplasmosis is identified, the treatment regimen begins immediately.
Toxoplasmosis of the organs of vision
Toxoplasmosis of the eye is one of the causes of vision problems, which, unfortunately, many people are not often aware of. The symptoms of this pathology are as follows:
- Pathological changes in the macular area, the formation of atrophic pigment foci, complaints of deterioration in the quality of vision.
- Lack of transparency of the vitreous body, defects in inflammation in the visual organ, exfoliation of the posterior membrane against this background.
- Disorders of the optic nerve.
Toxoplasmosis of the eyes in people with a strong immune system is usually asymptomatic, only sometimes people complain of myopia and pain when blinking.
Congenital ocular toxoplasmosis. It is manifested by pronounced pathologies of the development of the eyeball, blindness, disorders of the spinal cord and brain.
Acquired toxoplasmosis of the eye. It becomes a consequence of the chronic form of the disease without pronounced clinical manifestations in adjacent areas.
The disease is currently treatable with chemotherapy and antibiotics. But usually it is not possible to stop the pathological process and restore lost health to the eyes, there are only chances to transfer ocular toxoplasmosis to the “fading” stage so that the disease does not progress further.
Toxoplasmosis in children
If a woman was first infected with toxoplasma during pregnancy, then her child will be diagnosed with congenital toxoplasmosis at birth. Symptoms of this pathology can be noticeable from the day of birth or a little later.
Congenital toxoplasmosis in newborns depends on when the mother was infected. Consider in the table how the infection of the future mother with toxoplasma affects the child.
If toxoplasmosis in children arose after birth, that is, the fetus was not infected in the womb, then the disease will have the same causes and symptoms as in adults, but in a slightly enhanced form. For example, the incubation period can be shifted up to 3 days.
Toxoplasmosis in men and women
Toxoplasmosis in men. The disease always has an acute onset, if timely treatment of the infection is not started, the disease easily turns into a chronic process. As a rule, pathology begins with banal symptoms, namely general weakness, sleep disturbance and appetite. During this time, destructive processes begin in the male body, and the pathology itself, if not cured, causes the following complications: cystitis, inflammation of the prostate, erectile dysfunction.
Toxoplasmosis in women. The disease has similar symptoms, therefore, after their appearance, diagnosis and treatment must necessarily follow. Toxoplasma can affect the reproductive organs of a woman, namely the uterus and ovaries, which later causes complications such as adnexitis, endometritis, menstrual disorders and infertility. The treatment of the disease is better in the acute stage, since during the remission of toxoplasmosis, the infectious agent already has time to firmly gain a foothold in the body and create colonies in the form of cysts. If a woman was infected before pregnancy, the fetus does not suffer.
Toxoplasmosis in pregnant and lactating mothers
As mentioned above, if a woman was infected with Toxoplasma 6 or more months before conception, the infection does not threaten the fetus. If less time has passed, then there is a risk that the mother is able to transmit the disease to the child, that is, the baby risks being born with a diagnosis of congenital toxoplasmosis.
If the diagnosis of acute or chronic toxoplasmosis is confirmed, this means that specific therapy is required to reduce the risk of infection of the fetus. But usually, such events do not solve the problem in full, that is, it will not be possible to avoid infection with this pathology by 100%, and since toxoplasmosis in children infected in utero ends very badly, most doctors insist on the only way - abortion, especially when it comes to It's about the first trimester.
When a disease is detected in the second and third trimesters of the expectant mother, etiotropic treatment and a mandatory study of the state of the fetal fluid are carried out.
This happens quite rarely. In other cases, breastfeeding may not be a cause for concern for the transmission of this disease.
Toxoplasmosis and HIV infection
Individuals with immunodeficiency are poorly protected from various infections, and toxoplasmosis in the presence of HIV is not something special. According to statistics, 95% of HIV patients have a cerebral form of the disease.
Symptoms of pathology in such individuals are due to damage to the central nervous system. In many patients, this disease leads to brain damage, with about 75% of patients experiencing mental problems, 33% with epilepsy, and 72% are diagnosed with unexplained fever and headaches.
Toxoplasmosis in cats and dogs
The fact that cats and dogs can not only get sick with this disease, but also transmit it to humans is a rather frightening fact, so many people perceive animal toxoplasmosis with caution. How to distinguish a sick animal from a healthy one?
The animal acts as an intermediate host in this pathology. Manifestations of the disease can be as follows:
- fever;
- sluggish behavior, rapid breathing;
- vomiting, diarrhea;
- neurological disorders: stupor, convulsions, etc.;
- eye diseases.
Toxoplasmosis in a cat is often accompanied by eye damage, that is, this symptom is detected much more often than other signs. All symptoms can be observed in an animal from several days to several months. At the same time, the clinical manifestations in cats may vary depending on the damage to specific organs, in accordance with which it is necessary to individually select the treatment of toxoplasmosis for the animal.
In a mild form, it is characterized by an asymptomatic course, in a severe form - by acute clinical manifestations: in 50% respiratory function disorders, in 25% digestive and 25% neurological. The disease in dogs is most often diagnosed at a young age, and the symptoms of the pathology in this case are usually generalized.
Symptoms in dogs in case of detection of toxoplasmosis will be as follows:
- fever;
- dyspnea;
- lack of appetite;
- vomiting, diarrhea;
- convulsions.
Unlike the disease in cats, the disease in dogs does not involve the eyes.
Currently, a specific vaccination against toxoplasmosis for animals has not been developed. Previously, before prescribing treatment, animals must be examined, that is, it is necessary to do an analysis for toxoplasmosis. A diagnosis made without laboratory diagnostics is considered unreliable.
So, how to treat toxoplasmosis in dogs and cats is shown in the following table.
Spiramycin can be used in pregnant animals.
When making a diagnosis, the specialist finds out the nature of toxoplasmosis - a disease or carriage.
Since the clinical manifestations of this disease are very diverse, the diagnosis of pathology is seriously complicated. Therefore, all patients must be tested for toxoplasmosis with subsequent interpretation of the results, for example, in the Invitro laboratory, where they will tell you in detail how to take tests to obtain an accurate test result. This is done in the following ways:
Immunological methods, the task of which is to determine the time of infection with Toxoplasma. With the enzyme-linked immunosorbent assay (ELISA), specialists detect antibodies in the blood to toxoplasmosis. For example, this can be done through the RIF technique or immunofluorescent reaction, which deciphers the presence of antibodies with the help of light. If a bright glow is detected, this means that antibodies have been detected for toxoplasmosis, the ELISA test is positive.
In general, with immunological diagnostics by ELISA, a class of immunoglobulins is studied; for this, a blood test for toxoplasmosis is taken from a vein. The presence of G antibodies to the pathogen in the blood indicates that the person has already had toxoplasmosis or is at the stage of recovery. If the ELISA method reveals immunoglobulins M, which should not be normal, then we are talking about acute toxoplasmosis and the need for treatment.
Also in Invitro, it is possible to detect the DNA of the causative agent of the disease in human biological fluids using the PCR method. Usually, for this purpose, venous blood is taken for toxoplasmosis. When detecting Toxoplasma DNA, we are talking about an inflammatory process in the body.
Treatment
Treatment of toxoplasmosis in adults and children is based on the relief of the pathological process.
But toxoplasmosis does not require intervention in all cases. If, during an ELISA study, a positive toxoplasmosis IgG was detected in a patient and there are no signs of the disease, in this situation there is no need to prescribe medications.
Treatment of acute toxoplasmosis
In combination with the above means, toxoplasmosis is additionally treated with sulfonamides and antibiotics, in particular macrolides and tetracyclines.
The situation when toxoplasmosis and pregnancy coincide also requires treatment, but in this case it is important not only to stop the pathology in a woman, but to prevent the risk of infection of the fetus. For this purpose, the doctor prescribes an antibiotic of the macrolide group - Rovamycin from the 16th week of pregnancy according to the scheme:
- 1 tab. (1500 million units) 2 times a day for 6 weeks;
- 1 tab. (3 million units) 3 times a day for 10 days.
Pregnant women can also be prescribed Aminoquinol from the 9th week and Chloridine from the 16th.
Treatment of chronic toxoplasmosis
Therefore, the chronic form of toxoplasmosis is treated with immunomodulators and antihistamines; UV radiation can be additionally applied.
Consider what immunostimulating therapy looks like in the table.
Desensitizing therapy is carried out with antihistamines Suprastin, Tavegil, etc. It is aimed at blocking the activity of H1-histamine receptors to reduce the risk of an allergic reaction.
Some patients are helped by the use of the ASD fraction (Dorogov's antiseptic stimulator), which has a wide spectrum of action. The drug is non-toxic, has no side effects, is well tolerated by the body, and most importantly, compatible with other medications.
Treatment of toxoplasmosis with folk remedies should be carried out with the permission of a doctor. You can not refuse the official therapy prescribed by a specialist if the treatment of toxoplasmosis is required in children and expectant mothers.
So, what folk recipes are effective for toxoplasmosis?
- Art. Pour a spoonful of calendula, elecampane, aspen bark, calamus and eucalyptus with a glass of boiling water and leave for about an hour. Take 3 times a day according to Art. spoon.
- Chop young branches of bird cherry about 100 g and pour 2 liters of water. Bring to a boil, keep on fire for another 20 minutes. Insist for 3 hours and drink 50 ml before meals 3 times a day for a course of 1 month.
- 100 g of propolis pour 0.5 liters of vodka, insist for 14 days. Take 40 drops 3 times a day before meals. The course is 7 days, then a break for 7 days and the course is repeated again, in total 4 such courses are required.
Prevention
Prevention of toxoplasmosis is usually aimed at preventing infection of the population. It includes the following points.
Therefore, if Toxoplasma enters the body of a healthy person with good immunity, in response to them, the formation of antibodies will begin, which will soon overcome the disease, subsequently developing stable immunity. However, if a person has a decrease in immunity, antibodies may be produced in insufficient quantities or absent altogether. In this case, there will be a predominance of toxoplasmosis, which will subsequently infect the body and cause such a disease as toxoplasmosis.
There are the following ranks of microorganisms:
- kingdom ( domain);
- kingdom;
- supertype;
- Class;
- order;
- family;
- subspecies.
Eukaryotes are higher organisms that have a common structure characteristic only for this domain. The main feature of a eukaryotic cell is the presence in it of a clearly defined nucleus, which contains a DNA macromolecule responsible for the storage, transmission and implementation of genetic information.
Eukaryotes include the following kingdoms:
- animals;
- plants;
- mushrooms.
There are seven types of protozoan microorganisms, which mainly differ from each other in their characteristic mode of movement.
Of the seven types of microorganisms, only three types can cause a specific disease in humans:
- sarcomastigophores ( Sarcomastigophora);
- ciliates ( Ciliophora);
- sporozoa ( Apicomplexa).
Note. Romanovsky-Giemsa staining is a cytological research method that allows you to differentiate the type of microorganism, as well as to study the chemical processes occurring in the cell.
ripening ( sporulation) cysts, after which they are considered infectious, occurs over a certain period of time, all depending on the temperature of the external environment.
At a temperature of plus four degrees Celsius sporulation occurs in two to three days.
At a temperature of plus eleven ripening occurs within five to eight days.
At a temperature of plus fifteen oocysts will take about three weeks to sporulate.
Note. Ripening of oocysts is impossible at temperatures below plus four and above plus thirty-seven degrees Celsius.
Depending on the gestational age, congenital toxoplasmosis can be divided into two groups:
- early congenital toxoplasmosis, in which the infection of the mother, and as a result, the fetus is carried out in the first months of pregnancy;
- late congenital toxoplasmosis, in which a pregnant woman becomes infected with toxoplasmosis and transmits the disease to the fetus in the second half of pregnancy.
With late congenital toxoplasmosis, a child may be born with signs of generalized toxoplasmosis ( eg, enlarged liver, spleen).
There are the following forms of congenital toxoplasmosis:
- acute form;
- chronic form.
| Symptoms of the acute form of congenital toxoplasmosis | Symptoms of the chronic form of congenital toxoplasmosis |
|
|
Symptoms of acquired toxoplasmosis
The following periods of the disease are distinguished:- incubation period;
- prodromal period;
- peak period;
- convalescence period.
| Disease period | Period duration | Period Description |
| Incubation period | three days to two weeks | It is characterized by the multiplication of pathogens and the accumulation of toxins. This period lasts from the moment the microorganism enters the body until the first symptoms appear. |
| prodromal period | within one to two weeks | It is characterized by the appearance of the first nonspecific clinical symptoms ( e.g. fever, malaise, swollen lymph nodes). This period may begin acutely or gradually. |
| peak period | two to three weeks | There is a subsidence of nonspecific symptoms of the disease. Also, there is a suppression of the vital activity of the immune cells of the body, which subsequently leads to the development of pathological conditions of the cardiovascular, musculoskeletal and nervous systems. |
| convalescence period | in the third - fourth week of the disease, there is a gradual disappearance of all clinical symptoms | It is characterized by the disappearance of signs of the disease and the onset of persistent immunity, which is developed for life. |
Note. In a healthy person, this disease, as a rule, proceeds almost imperceptibly, without pronounced symptoms. The patient may experience symptoms such as a slight increase in body temperature, weakness, headache, swollen lymph nodes, which usually disappear within one week. However, if a person has a decrease in the body's defenses ( such as HIV infection), then toxoplasmosis is more pronounced with damage to various systems, organs and tissues ( e.g. nervous system, heart, eyes, skeletal muscles).
There are three forms of acquired toxoplasmosis:
- acute form;
- chronic form;
- latent form.
acute form
This form in most cases is characterized by an acute onset of the disease.In the acute form, the patient may experience the following symptoms of the disease:
- an increase in body temperature to 38 - 39 degrees;
- signs of intoxication of the body, for example, decreased appetite, muscle and joint pain, weakness ( develop as a result of internal effects on the body of toxins, which are released by the causative agent of the disease);
- swollen lymph nodes, in most cases cervical and occipital ( increase in size, become dense);
- hepatosplenomegaly ( enlargement of the liver and spleen).
Chronic form
It is characterized by various manifestations for a long time. With this form of the disease, there is a long ( within a few months) an increase in body temperature within 37 - 37.9 degrees, as well as manifestations of intoxication of the body, which can subsequently lead to damage to various organs and systems ( e.g. damage to eyes, heart, muscular system).During this period, the patient may be disturbed by symptoms such as increased weakness, nervousness, headaches, memory impairment, as well as pain in the muscles and joints. It should also be noted that the chronic form is characterized by an increase in lymph nodes - usually cervical, supraclavicular, axillary and inguinal.
The chronic form of toxoplasmosis can lead to damage to the following body systems:
- gastrointestinal tract;
- the cardiovascular system;
- nervous system;
- endocrine system;
- visual system.
- loss of appetite;
- violation of the chair;
- weight loss;
- pain in the abdomen;
- enlargement of the liver and its soreness;
- dysfunction of the pancreas.
- increased heart rate ( tachycardia);
- drop in blood pressure ( below 120 to 80 millimeters of mercury);
Damage to the nervous system with toxoplasmosis can lead to the development of the following symptoms:
- emotional instability;
- irritability;
- decrease in working capacity;
- violation of the menstrual cycle;
- hypothyroidism.
- chorioretinitis ( inflammation of the choroid and retina);
- uveitis ( choroid inflammation);
- conjunctivitis ( inflammation of the conjunctiva);
- iritis ( inflammation of the iris).
- pain in the eyes;
- hyperemia ( redness) eye;
- lacrimation;
- increased sensitivity to light stimuli;
latent form
This form of toxoplasmosis is characterized by an asymptomatic course, and, as a rule, the disease is detected only after research.Diagnosis of toxoplasmosis
Diagnosis of toxoplasmosis includes:
- collection of anamnesis;
- examination of the patient;
- laboratory research;
- instrumental diagnostics.
Collection of anamnesis
History taking includes:- medical history ( chronological description of the onset of symptoms of the disease);
- anamnesis of life ( description of living conditions, eating habits, profession);
- epidemiological history ( it turns out whether there was contact with animals, the nature of the contact);
- allergic history ( Are you allergic and what exactly?).
Examination of the patient
Examination of a patient with toxoplasmosis in the acute periodWhen examining a patient in this period, the doctor reveals:
- increased body temperature ( usually subfebrile);
- enlargement of the liver and spleen ( liver tender on palpation);
- swollen lymph nodes ( soft in density, painful on palpation, the value varies within one to one and a half centimeters, not connected to nearby tissues).
Examination of a patient with toxoplasmosis in the chronic period
| System | Examination of the patient | Patient's complaints |
| The cardiovascular system |
| The patient may complain about pain in the region of the heart, as well as weakness. |
| Gastrointestinal tract | On palpation of the abdomen, there are pains in the epigastric area of a dull nature, bloating, and an increase in the size of the liver ( painful on palpation). | The patient may complain of decreased appetite, dry mouth, nausea, constipation, and weight loss. |
| Musculoskeletal system | On palpation of the muscles, the doctor can detect seals, as well as muscle hypertonicity, which is accompanied by painful sensations. Also, during the examination, there is a limitation of joint mobility. | Painful sensations in the muscles usually in the upper and lower extremities, lower back) and joints of large or medium size ( e.g. knee, elbow, ankle). Also, the patient may complain about muscle weakness. |
The study of the nervous system reveals:
- weakness;
- apathy;
- decrease in performance.
Due to the fact that this period is characterized by an asymptomatic course, the examination of the patient is based on laboratory diagnostics and subsequent analysis of the results of the study.
Laboratory research
Serological methodIt is an effective method for diagnosing infectious and inflammatory diseases. This study is carried out by taking venous blood and then centrifuging it to obtain serum, that is, the liquid part of the blood.
Then the obtained material is examined for the presence of specific antibodies in the blood serum:
- Ig detection ( immunoglobulin) M means the presence of an acute process;
- detection of Ig G indicates a transferred process.
The following serological tests are used in the diagnosis of toxoplasmosis:
- complement fixation reaction;
- Sebin-Feldman reaction;
- immunofluorescence reaction ( REEF);
- linked immunosorbent assay ( ELISA).
| Reaction name | Description of the reaction |
| Complement fixation reaction | When the antigen and antibody bind, a special protein, complement, is subsequently attached, which leads to the formation of an immune complex. If the antibody and antigen do not bind to each other, then the complement, therefore, is not able to attach to them, as a result of which the absence of the complex is observed. The complement fixation reaction is carried out by detecting the presence of the formed complex or its absence. With toxoplasmosis, this reaction will be positive starting from the second week of the disease. |
| Sebin-Feldman reaction | The essence of this method is that normally the contents of a living cell are stained blue with the use of methylene blue. However, in the presence of antibodies in the serum, staining does not occur. Carrying out this reaction is possible only in the presence of live "Toxoplasma gondii". |
| Immunofluorescence reaction(REEF) | The material taken for research is applied to a glass slide in the form of a smear, which is subsequently processed with a special dye - fluorochrome. The serum of the dye, entering into contact with the proteins of bacteria during microscopic examination, causes their peripheral luminescence in the form of green ( direct reaction). Also, this research method can be carried out using an indirect reaction, which consists in the fact that the antiglobulin serum used is stained with fluorochrome and applied to a smear. This serum allows you to detect the presence of an antibody-antigen complex. Positive immunofluorescence reactions are observed starting from the first week after infection with toxoplasmosis. |
| Linked immunosorbent assay(ELISA) | Thanks to this analysis, it is possible to detect the presence in the blood of antibodies of the class Ig M, Ig G, Ig A or antigens of certain infections. ELISA helps to establish not only the existence of antibodies in the test material, but also to determine their number. |
Note. The final diagnosis of toxoplasmosis is established only after repeated examination of the serum.
Allergological method
This research method consists in the fact that the patient is given an allergic test by introducing toxoplasmin intradermally. The drug is injected into the outer area of the shoulder in an amount of 0.1 ml.
Note. Toxoplasmin is a special antigenic complex of the pathogen, which is obtained by taking fluid from the abdominal cavity of white mice suffering from toxoplasmosis.
At the site of injection of toxoplasmin, redness may be observed on the surface of the skin ( hyperemia) and infiltrate ( accumulation of injected substance in tissues).
When conducting an allergic test, the following reactions can be observed:
- strongly positive reaction (if the size of the intradermal reaction is more than twenty millimeters);
- positive reaction (if the size of the intradermal reaction is from thirteen to twenty millimeters);
- weakly positive reaction (if the size of the intradermal reaction is from ten to thirteen millimeters);
- backlash (if the size of the intradermal reaction is less than nine millimeters).
However, if a woman was found to have antibodies M or A during the study, as well as toxoplasmosis occurs with a pronounced clinical picture and damage to organs and systems is observed, then in this case a complex treatment of the disease is prescribed ( e.g. chemotherapy, antibiotics, desensitization therapy). Adequately selected therapy helps to significantly reduce the severity of toxoplasmosis, as well as prevent damage to internal organs.
Note.
Treatment of toxoplasmosis ( drugs and duration of treatment) is selected individually by the attending physician.
Treatment of toxoplasmosis is established depending on the following indicators:
- existing form of the disease;
- the severity of the course of the disease;
- degree of damage to organs and systems of the body.
Treatment of the acute form of toxoplasmosis
With toxoplasmosis, chemotherapeutic drugs are effectively used that act depressingly on toxoplasma in the trophozoite stage. The main representatives used in the treatment of this disease are antimalarial drugs that have an antimalarial effect, and also have a detrimental effect on the causative agent of toxoplasmosis "Toxoplasma gondii".| Name of the drug | Active substance | |
| Chloridine
(Daraprim) | Pyrimethamine |
in the first days of treatment, the drug is administered orally at a dose of 50 mg per day, in the subsequent days it is reduced to 25 mg per day. Children 2 to 6 years of age:
Children less than two years of age:
The duration of treatment, as a rule, includes three cycles. The drug is taken for five days, after which a seven-day or ten-day break is made, and the drug is repeated again. To enhance the therapeutic effect, pyrimethamine can be administered in combination with sulfadiazine. Adults and children over six years of age:
Children 2 to 6 years of age:
Children less than two years of age:
The above doses of sulfadiazine are administered in four divided doses. |
| Fansidar | pyrimethamine, sulfadoxine | Adults:
it is indicated to take two tablets once every seven days for six weeks. In the event that damage to the central nervous system is observed with toxoplasmosis, the drug is prescribed in combination with spiramycin ( macrolide antibiotic) in the amount of three grams per day, for three to four weeks. |
| Aminoquinol | Aminoquinol | Adults:
the drug is administered orally in the amount of 100-150 mg three times a day for seven days. The duration of treatment includes three cycles of seven days with ten-fourteen-day breaks between them. To increase the effectiveness of the drug can be prescribed in combination with sulfadimezin at a dose of two grams, two to three times a day ( for adults). |
Note. This treatment negatively affects the bone marrow, which consumes large amounts of folic acid to renew tissues. Therefore, from the beginning of treatment, in order to compensate, the appointment and parallel intake of folic acid in the amount of six to ten milligrams per day is recommended. It should also be noted that the course of therapy should be carried out under regular monitoring of peripheral blood.
In acute toxoplasmosis, antibiotics such as sulfonamides, tetracyclines, and macrolides can be prescribed in combination with antimalarial drugs or individually ( act depressingly on various microorganisms, including toxoplasma).
| Name of the drug | Active substance | Method of application of the drug and its dosage |
| Biseptol | sulfamethoxazole, trimethoprim () | Adults:
the drug is administered orally at 960 mg twice a day.
Children from three to five years old:
The duration of treatment is prescribed individually, but, as a rule, therapy is carried out in two to three cycles of ten days each. Note. In parallel, folic acid may be prescribed ( six to ten milligrams per day). |
| Sulfapyridazine | Sulfamethoxypyridazine (pharmacological group - sulfonamides) | Adults
on the first day, oral administration of one gram of the drug is indicated, after which the dose is reduced to 500 mg once a day. Children:
The duration of treatment is five to seven days. |
| Lincomycin hydrochloride | Lincomycin (pharmacological group - lincosamides) | Adults:
should be taken orally 500 mg two to three times a day. Children from three to fourteen years of age:
The duration of treatment is set individually depending on the available indications. |
| Metacycline hydrochloride | Metacycline (pharmacological group - tetracyclines) | Adults:
take orally 300 mg twice a day. Children from eight to twelve years of age:
The duration of treatment is usually seven to ten days. |
| Metronidazole | Metronidazole (pharmacological group - synthetic antibacterial drug) | Adults:
take 250 mg orally twice a day for seven to ten days ( depending on indications). Children five to ten years of age: shown 375 mg, divided into two doses, for seven to ten days. Children from two to four years old:
Children under one year old:
|
| Rovamycin | Spiramycin (pharmacological group - macrolides) | Adults:
the drug is administered orally in the amount of six to nine million international units ( two to three tablets) two to three times a day. children(over twenty kilograms):
The duration of treatment is determined individually by the attending physician. |
Treatment of acute toxoplasmosis in pregnant women
Treatment during pregnancy aims not only to cure the disease in the mother, but also to prevent the development of congenital toxoplasmosis in the child.In the treatment of acute toxoplasmosis in pregnant women, in most cases, the drug Rovamycin is used, which after the sixteenth week is prescribed to a woman in the following dosage:
- inside one tablet ( 1.5 million action points) twice a day for six weeks;
- inside one tablet ( 3 million action points) twice a day for four weeks;
- inside one tablet ( 3 million action points) three times a day for ten days.
To prevent congenital toxoplasmosis, a pregnant woman may be prescribed the following drugs:
- chloridine;
- aminoquinol.
The drug is prescribed from the sixteenth week of pregnancy. Treatment includes two cycles with an interval of ten days or three cycles with an interval of a month.
Aminoquinol
The drug is prescribed starting from the ninth week of pregnancy.
Treatment consists of four cycles:
- first cycle- ninth - fourteenth week of pregnancy;
- second cycle- fifteenth - twentieth week of pregnancy;
- third cycle- twenty-first - twenty-six weeks of pregnancy;
- fourth cycle- twenty-seventh - thirty-second week of pregnancy.
Treatment of the chronic form of toxoplasmosis
As indicated, the above drugs act on the causative agent of toxoplasmosis when they are in the trophozoite stage. However, in the chronic form of the disease, Toxoplasma in the human body is in the form of cysts, so antimalarial and antibacterial drugs do not have the desired therapeutic effect ( drugs are not able to penetrate into the cysts) and, as a rule, are not used in the treatment of this stage of the disease.Treatment for the chronic form of toxoplasmosis includes:
- taking immunostimulating drugs;
- conducting a desensitizing ( antiallergic) therapy;
- the introduction of toxoplasmin;
- conducting ultraviolet irradiation.
These drugs are used in complex therapy for the treatment of toxoplasmosis, acting favorably on the body's defenses, they stimulate cellular and humoral immunity.
This therapy is necessary because the existing chronic infection has a negative impact on human immunity, significantly reducing it.
| Name of the drug | Method of application of the drug and its dosage |
| Likopid | The drug is taken orally at a dose of one to two milligrams per day for ten days. |
| Taktivin | Adults:
the drug is administered subcutaneously in the amount of one milliliter once, daily in the evening for five to fourteen days. Children from six months to fourteen years:
|
| Cycloferon | Adults:
three to four tablets are prescribed ( 150 mg) once a day. Children from seven to eleven years of age:
Children aged four to six years:
|
| Thymogen | The drug is administered intramuscularly in the following dosage:
|
Desensitizing therapy
The mechanism of action of this group of drugs is that they block H-1 histamine receptors, which leads to a decrease or elimination of an allergic reaction.
| Name of the drug | Method of application of the drug and its dosage |
| Suprastin | Adults:
one tablet is indicated ( 25 mg) three to four times a day. Children from six to fourteen years of age:
Children from one to six years of age:
Children from one month to one year:
|
| Diazolin | Adults:
take orally 100 - 300 mg ( one tablet contains 100 mg) per day. Children five to ten years of age:
Children from two to five years old:
Children under two years of age:
|
| Tavegil | Adults:
inside one tablet ( one milligram) two to three times a day; as an injection intramuscularly or intravenously in the amount of two milligrams twice a day ( in the morning and in the evening). Children from six to twelve years of age:
Children from one to six years of age:
|
Note. Desensitizing and immunostimulating therapies are also used in the treatment of acute toxoplasmosis.
Specific immunotherapy with toxoplasmin
Before starting immunotherapy with toxoplasmin, an allergic test is first made at 0.1 ml intradermally in three weak concentrations, followed by reading the result a day later. In the absence of a local and general reaction to the administration of the drug, a more concentrated dose of toxoplasmin is administered after 24 hours. Then, a day later, an even more concentrated dose of 0.1 ml is injected intradermally into four different points, which subsequently causes a general and local reaction. The response is evaluated every day. As soon as the reaction subsides, the drug is administered again, while the concentration of toxoplasmin is increased, and the points at which the drug is injected are eventually increased to ten.Note. The introduction of toxoplasmin is performed if the patient does not have diseases associated with eye damage.
ultraviolet irradiation
Treatment, as a rule, begins with the appointment of a quarter of the biological dose, observing the reaction of the skin, the dose is increased daily or every other day by a quarter.Prevention of toxoplasmosis
Prevention of toxoplasmosis is as follows:- compliance with the rules of personal hygiene;
- reduced contact with cats;
- exclusion of eating raw, as well as poorly fried or boiled meat or minced meat;
- when eating vegetables, fruits or berries in contact with the ground, they should be thoroughly washed;
- if you have a cat at home, it is recommended to regularly examine the animal for toxoplasmosis;
- when planning a pregnancy, a woman should be tested for toxoplasmosis;
- strengthening the body's defenses regular hardening, good nutrition, maintaining a healthy lifestyle).
Instruction
Toxoplasmosis can manifest itself in several clinical forms: acute, chronic and latent. The disease is dangerous because it is often asymptomatic. The acute form of toxoplasmosis is characteristic of people with weakened immune systems. It poses a threat to health and life, has a severe course and causes complications. Toxoplasmosis affects all organs and systems, so the disease manifests itself with a variety of symptoms, which depend on which organ is more affected. The main clinical manifestations can be: an increase in body temperature to 38 ° C and above, chills, weakness, headache, sleep disturbances, drowsiness, swollen lymph nodes, decreased muscle tone, symptoms of CNS damage (memory disorder, fear, appearance).
Toxoplasmosis is diagnosed taking into account the symptoms and on the basis of the results of laboratory and instrumental research methods. To be tested for this disease, you need to donate blood for analysis. To diagnose toxoplasmosis, serological methods are used (the study of antigens or antibodies in the patient's biological material). These include: ELISA (enzymatic immunoassay), RNIF (indirect immunofluorescence reaction), RSK (complement fixation reaction). The reaction of indirect immunofluorescence is a rather sensitive test, starting from the 1st week. diseases. It reaches its maximum after 2-4 months. from the moment of infection. In the chronic form of the disease, it is indicative for many years.
The complement fixation reaction can reveal the pathogen, starting from the 2nd week, it reaches its maximum manifestation by 2-4 months. illness. Then the indicator can be negative or weakly positive, which can make it difficult to diagnose the latent and chronic form. The most effective blood test is the ELISA method, which determines the immunoglobulins (antibodies) of the IgG and IgM classes. This analysis allows you to identify toxoplasmosis and distinguish its forms. An additional diagnostic method is KP (allergic skin test) with toxoplasmin. It becomes positive, starting from 4-6 weeks. infection, and may persist throughout the life of the patient.
In a general blood test for toxoplasmosis, a decrease in the number of leukocytes (leukopenia) is detected or a normal number of leukocytes is detected with a slight increase in the fraction of lymphocytes. Instrumental methods for diagnosing toxoplasmosis are: X-ray examination, examination of the fundus, biopsy of the lymph nodes. For a woman, the most dangerous is the primary infection with toxoplasmosis during pregnancy. When infection occurs before conception, protective IgG antibodies will be detected in blood tests. In this case, the percentage of complications will be small.