Toxoplasmosis - a parasitic disease,characterized by lesions of the nervous system, eye, skeletal muscle and cardiac muscle, and enlarged lymph nodes, liver and spleen. Prone to chronic course.
Pathogen - Toxoplasma gondii - an intracellulara parasite belonging to the simplest. The final master it is a domestic cat, are excreted in the feces of Toxoplasma, which are capable of long-term (up to 2 years) persist in the environment and infect many species of animals and humans. Other animals are the intermediate hosts. Human infection occurs through contact with cat feces, with the earth and sand contaminated by them, as well as for testing of ground beef or use insufficiently cooked meat. Lamb and pork often contain Toxoplasma (from 10 to 25%). Contact with dogs, farm animals to infect humans does not. A sick person is not contagious to others.
Transmission of Toxoplasma is also possible for the transplantorgans of infected donors, and intrauterine infection of the fetus from the mother through the placenta. Accordingly, the method of infection distinguish congenital and acquired toxoplasmosis.
Infection atriums are the digestive organs,Toxoplasma introduced into the small intestine and reach its lymph nodes where multiply, causing inflammation. Then the parasites enter the bloodstream and spread throughout the body and "settle" in a variety of tissues and organs: liver, spleen and lymph nodes, where they sometimes persist for life. Defenses in most cases prevent the development of disease, however, when weakening it develops. The disease can occur 10-20 years after infection.
Most of the infected are no clinicalmanifestations of the disease. In some patients there is lingering and chronic forms rarely - acute, with severe disease. In utero infection during the first months of pregnancy often occurs miscarriage and fetal death. It does not rule out the possibility of fetal malformations of the fetus and the birth of children with developmental defects. If the infection occurred in the later stages of pregnancy, the baby is born with a generalized toxoplasmosis.
Manifestations of acquired toxoplasmosis
Most infected Toxoplasmaclinical manifestations of the disease are absent, however, in some infected within 2-3 weeks - several months formed an acute acquired toxoplasmosis. As a rule, acute acquired toxoplasmosis begins gradually. At the same time, patients may not accurately indicate the beginning of the disease.
The main complaints of patients are increasedfatigue, decreased performance, fatigue, chilliness, raising the temperature to 38.5 ° C, there may be a slight headache, pain in muscles and joints.
At the end of 2.3 weeks the disease in patientsthere is swelling of the lymph nodes (small, up to 2 cm in diameter), nodes moderately painful or painless at palpation. Most often there is an increase zadnesheynyh, neck, rarely axillary, subclavian and proper and very rarely groin. Most patients with acute acquired toxoplasmosis noted an increase in the liver. The spleen is increased less.
Manifestations Chronic acquired toxoplasmosisa
The most common form of toxoplasmosis. characterized by prolonged fever Chronic acquired toxoplasmosis to 37.2 - 37.6about Since that is not treatable by conventionalmeans. Central nervous system is manifested in the form of sluggish encephalitis, arachnoiditis, vegetative-vascular disorders, manifested by headaches, memory impairment, decreased interest in things, sleep disturbance, weakness, weakness, different fears, compulsions. At the same time, patients complain of constantly increasing general weakness, fatigue, loss of appetite, lack of a sense of vivacity after sleep. They become irritable, long night can not sleep, wake up at night and in the morning they are concerned about weakness and a bad mood. They are often concerned about the dull headache, pain in joints and muscles. There is increased sensitivity to sound and light stimuli, unstable mood, intolerance. In chronic toxoplasmosis is characterized by loss of lymph nodes, enlarged liver and spleen. This often increases zadnesheynye, cervical, axillary and inguinal lymph nodes. The defeat of the cardiovascular system associated with damage to the heart muscle and appears heartbeat, compressing and pressing pains in the heart, arrhythmias, blood pressure reduction. Involvement of the gastrointestinal tract appears dry mouth, decreased appetite, dull abdominal pain, bloating, and gas delay.
Endocrine disorders are characterized bymenstrual irregularities in women, impotence in men, pancreatic lesions. Some women have habitual miscarriage. Violation of the organ of vision can be in the form of chorioretinitis, uveitis, progressive myopia.
The defeat of the musculoskeletal system due to themainly affecting the muscles and manifested by pain in the muscles of legs, hips, waist, less frequently - in the muscles of the back, neck, arms. Sometimes muscle pain is so strong that impede movement.
Congenital toxoplasmosis - a disease of children,resulting from contamination during fetal development. Infection of the fetus from the mother occurs only in case of an acute infection of the woman during pregnancy, when the pathogen with blood can get into the placenta. It formed the site of infection, where toxoplasma with blood fall to the fetus. Women infected with toxoplasmosis before pregnancy (chronic or latent infection), transmission of the pathogen has not been proved in the fetus because the mother's immune system protects the fetus from infection.
Severity of clinical manifestations depends ontime of intrauterine infection of the fetus. If this happens in the first trimester (the infection of the fetus is possible in 15-30% of cases) at the birth of a child is formed chronic congenital toxoplasmosis with severe lesions in the form of hydrocephalus, microcephaly, chorioretinitis, microphthalmia, areas of calcification in the brain, the backlog psychomotor development. Usually this pregnancy ends in miscarriage. Do not try to keep this pregnancy as curative interventions in children with chronic congenital toxoplasmosis almost do not bring positive results.
While infecting pregnant in II-nd trimester(Infection of the fetus at the same time is observed in 25% of cases) in the newborn is formed subacute congenital toxoplasmosis. In such cases, affected most of the central nervous system - develop encephalitis (inflammation of the brain), the defeat of the cranial nerves, flabby paralysis and paresis, chorioretinitis with the formation of the subsequent blindness. With timely diagnosis in the newborn congenital toxoplasmosis is a subacute chemotherapy.
While infecting pregnant III-eat trimester(Infection of the fetus during this occurs in 65-70% of cases) is formed by a sharp congenital toxoplasmosis, which is manifested by fever, irritability, swollen lymph nodes, loss of appetite, rash, enlarged liver and spleen, lesion of the cardiovascular system (myocarditis). If the fetus is dead, the visible signs of the disease soon after birth: common skin rash, fever, liver disease, encephalitis, brain edema, eye damage. The disease may progress and end with the death of a child in the first weeks of life, or become chronic. It is noted the child's developmental delay, especially mental. May develop dementia, impaired speech development. Marked slowing of physical development: children do not eat, are stunted. They may develop blurred vision.
Sometimes congenital toxoplasmosis can occur between the ages of 10-15 years.
Diagnosis of toxoplasmosis
Toxoplasmosis should be suspected in caseslong a slight increase in body temperature. The diagnosis is confirmed by special blood tests - identifying specific for toxoplasmosis antibodies in the blood. The most sensitive and specific method for diagnosing toxoplasmosis is linked immunosorbent assay (ELISA), i.e. detection of antibodies of classes IgM and IgG to Toxoplasma.
Screening for toxoplasmosis are the following:
- necessarily all pregnant women in early pregnancy as much as possible (ideally - to her);
- women suffering from infertility and miscarriage (abortions up to 12 weeks).
In acute toxoplasmosis usedchemotherapy drugs and antibiotics. Treatment of chronic toxoplasmosis is much harder than acute, as chemotherapy has no significant effect. The main place is allergen and immunomodulatory therapy. The range of treatments include vitamins, desensitizing agents, lidazu, cerebrolysin etc.
There is a positive effect of levamisole in the treatment of chronic toxoplasmosis. Levamisole is assigned to 150 mg for 3 consecutive days with 1 week intervals between cycles, only 2 - 3 cycles.
Prevention of toxoplasmosis
Preventing infection with ToxoplasmaI am eating only well-heat-treated meat and meat products, clean-washed vegetables, fruits and berries. In the process of cooking it is prohibited to taste raw ground beef. It is necessary to thoroughly wash your hands after handling raw meat products, work in the garden, the garden, the children after playing in the playground, and especially in the sandbox. It is necessary to carefully follow the hygiene rules of detention in the apartment pets, do not forget to wash your hands after contact with them.
In the event of pregnancy, every womanIt should be screened for toxoplasmosis in antenatal clinic. In identifying a pregnant clinical manifestations of toxoplasmosis, as well as the detection of antibodies to Toxoplasma class IgM, should decide on the need for treatment or abortion.