Toxoplasmosis

Toxoplasmosis is a parasitic disease characterized by chronic course, nervous system damage, lymphadenopathy, mesadenitis, frequent myocardial damage, muscles and eyes. The main host of the parasite is the cat, which excretes oocytes with feces, capable of remaining in the soil for up to a year. A person becomes infected when oocysts get into the digestive tract. Other animals do not pose any danger. From them you can get infected only by eating raw meat (minced meat). A sick person does not represent a danger to others. In case of infection during pregnancy, intrauterine infection of the fetus is possible.

Etiology, pathogenesis. Pathogen - toxoplasm, refers to the simplest. In the human body and other intermediate hosts exists in the form of trophozoites, which multiply intracellularly. These forms are very unstable in the external environment, are inactivated under the influence of chemotherapeutic drugs. In addition, the body produces cysts, which are a congestion of a large number of parasites, surrounded by a dense shell. Cysts are very stable and do not die under the influence of chemotherapeutic drugs. Gates of infection are the digestive organs. The introduction of the pathogen occurs in the small intestine; With a current of lymph of toxoplasm get into regional lymph nodes where inflammatory changes occur. Hematogenous toxoplasma falls into various organs and tissues, where cysts are formed that persist in the human body for dozens of years and for life. There is an allergy of the body and the production of antibodies. Infection often occurs in a latent form, but with a weakening of the defenses of the body, the disease may become worse, and with a sharp suppression of the immune system (the use of immunosuppressants, AIDS), a generalized infection with severe encephalitis can develop.

Symptoms, course. Toxicoplasmosis usually begins as a primary chronic disease from the moment of infection to the first manifestations of the disease can take many months. There are congenital and acquired toxoplasmosis. Congenital toxoplasmosis can develop only if a woman is infected during pregnancy. More often it is manifested in the form of encephalitis and eye damage. The presence of toxoplasmosis infection of a woman before pregnancy does not lead to congenital toxoplasmosis.

The majority of infected toxoplasmosis is latent without any clinical manifestations. Among the manifest forms, chronic (in 99%) prevails and very rarely there is acute toxoplasmosis, occurring more often in the form of encephalitis. Chronic form can last for many years with periodic exacerbations and remissions. The most frequent manifestations are prolonged subfebrile condition, generalized lymphadenopathy, myositis, mesadenitis, liver enlargement, ECG changes, functional changes in the CNS (in 50-90% of patients), spleen enlargement, chorioretinitis and uveitis, miscarriage less often (in 10- 20% of patients).

To detect infection, use an intradermal test with toxoplasmin and serological reactions (usually RCC). Since about 20-30%

Of the population, positive specific reactions are of little informative for diagnosis. Negative reactions (especially intradermal allergic test) allow excluding toxoplasmosis. The main diagnostic value belongs to clinical data. It is necessary to differentiate from other chronic diseases (rheumatism, chronic tonsillitis, brucellosis, etc.).

Treatment. In acute forms of toxoplasmosis, etiotropic therapy is the basis. Assign chloridine to 0.025 grams 2-3 times a day and sulfadimezin 2-4 g per day for 5-7 days. Usually spend 3 courses with an interval of 7-10 days. In chronic forms etiotropic therapy is ineffective. Apply a complex treatment, which includes one (5-7 days) course of etiotropic treatment (tetracyclines, delagil, metronidazole chloride with sulfadimezinom, biseptol, etc.) in combination with nonspecific desensitizing therapy (antihistamines, corticosteroids), vitamins. Vaccine therapy (toxoplasmotherapy) is of primary importance. Select an individual dose (dilution of toxoplasmin). Then it is injected intradermally in a growing dosage under the control of individual sensitivity. Pregnant women with positive reactions to toxoplasmosis, but without clinical manifestations of the disease are not subject to treatment. The appointment of chemotherapeutic drugs (especially chloride and sulfadimezin) in the early stages of pregnancy (the first 3 months) is categorically contraindicated, since they can cause the occurrence of malformations.

Forecast. With chronic acquired toxoplasmosis, one course of complex therapy leads to a stable recovery of 85% of patients; In 15% at various intervals of time, recurrences occur that require treatment. Individual patients may have residual effects that impair their ability to work (reduced vision, damage to the nervous system). In acute forms, the prognosis is serious.

Prevention. Observance of hygienic rules, with the maintenance of cats, prohibition of consumption (testing) of raw minced meat and meat dishes without sufficient heat treatment.