Toxoplasma gondii. Toxoplasmosis in humans: symptoms, ways of infection, diagnosis and treatment

A parasite, known as Toxoplasma gondii, can cause infection of the human body and some animals. This disease is called toxoplasmosis. Parasites that cause it are single-celled organisms that have a rather complex development cycle.

Ways of infection

Many know that the vectors of the disease are cats. It is because of this that some people are afraid to touch them and try to avoid them in every possible way. But the danger is only cat feces, it is in them that the Toxoplasma gondii parasite is located. You can also become infected if you eat raw meat of animals that were affected by the disease. Another way of transmission is a blood transfusion from a sick person to a healthy person. Also, intrauterine infection of the fetus from a sick mother can occur. But with the mother's milk, toxoplasmosis is no longer transmitted.

Cats can become infected with this disease when eating sick animals. Because its carriers can be birds, rodents. Pets can be infected by eating raw meat from other animals. Cats are the ultimate masters of parasites, it is in their intestines that toxoplasma begins to multiply, microorganisms are released into the environment along with feces.

Man is only an intermediate master of parasites. Once in the body, Toxoplasma gondii can circulate in the blood, deposited in the muscles, brain, eyes and other tissues. They destroy cells and form cavities in them - cysts or pseudocysts. They can also form calcintates - parasites are impregnated with calcium salts.

Symptoms of the disease

The final diagnosis can be made only after laboratory tests. If antibodies of Toxoplasma gondii are detected in the serum , then we can say that the person is definitely sick. The danger of the disease lies in the fact that it often occurs asymptomatically. Therefore, people simply do not know that they can have toxoplasmosis. Symptoms in humans can manifest themselves only in rare cases. As a rule, this happens with those people whose body is weakened by another disease.

So, you can suspect that something is wrong, if:

• Axillary lymph nodes are enlarged , they can be palpated - they resemble round dense formations;

• the temperature rises - it is usually subfebrile, but sometimes it can reach 39 degrees;

• There is a pain in the right hypochondrium, while the examination establishes that the size of the liver and spleen is increased.

The disease can be accompanied by weakness and pain in the muscles. But in most cases the disease does not appear, its acute phase passes asymptomatically in a couple of weeks.

Types of toxoplasmosis

Doctors distinguish several varieties of the disease. So, a specialist can diagnose congenital, ophthalmic, common, cerebral, acute toxoplasmosis as a result of the examination, as well as an affliction affects the central nervous system. Each of the subspecies of the disease has its own characteristics. Knowing them, the doctor may suspect one or another toxoplasmosis. Symptoms in a person, say, with a cerebral type of disease can be as follows:

• headaches, weakness;

• loss of sensitivity in certain areas of the body;

• sensation of goosebumps;

• Paralysis.

Sometimes with toxoplasmosis of the brain, a person can fall into a coma. The development of this type of pathology is possible in persons with weakened immunity, it is diagnosed, as a rule, in AIDS patients, in cancer patients after chemotherapy and in other diseases.

In some cases, ocular toxoplasmosis is diagnosed. Photos of people suffering from such problems do not allow to determine this disease. It manifests itself with pain and a sense of "fog" in the eyes, a decrease in visual acuity, sensations of flares. Sometimes an infection can lead to a complete loss of vision. Most often, eye damage is a manifestation of the congenital form of this disease.

In people whose immunity is weakened by chemotherapy or AIDS, widespread toxoplasmosis may appear. Symptoms in humans immediately make themselves felt. After all, with this form of disease affects the heart muscle, lungs. Vital organs become inflamed and may stop functioning. This can eventually lead to death.

Problems with pregnancy

To all future mothers, gynecologists are advised to check whether they are sick with such a disease as toxoplasmosis. Symptoms in a person are usually not expressed, so a pregnant woman may not even know that she has contracted. Of course, if the expectant mother had recovered before the conception of the crumbs, then the disease is no longer a danger to the fetus. And infection during pregnancy can lead to sad consequences. The most dangerous is considered to be infection in the first trimester.

Thus, infection with toxoplasmosis can cause miscarriage or fetal death in the uterus. In addition, infants infected in the womb may die soon after birth. If the child was able to survive, then his health can inflict irreparable damage to toxoplasmosis. Photos of these children are different, because the disease causes a number of congenital malformations. So, the consequences of intrauterine infection include:

- inflammation of the retina of the eyes and small vessels inside - chorioretinitis (can cause blindness);

- deafness;

- enlarged sizes of the spleen and liver;

Red nodular rash over the body;

- jaundice, which changes the color of the sclera of the eyes, mucous membranes and skin crumbs;

- Disproportionate head size of the newborn: it may be too small or, conversely, large;

- delay in the development of the baby.

The course of the disease in adults

If a person with normal immunity is infected with toxoplasmosis, then the disease, most likely, he does not show up. He may feel a few days of weakness, and the temperature can rise to subfebrile values. But this condition is unlikely to lead anyone to the idea that it is necessary to pass an analysis for toxoplasmosis.

If a woman has contracted before pregnancy, then the baby is already not threatened. To find out the approximate period of infection, special tests will help. To do this, when examining the blood, the doctor may recommend several titres. For example, antibodies to toxoplasm IgG say that the infection has been transferred for a long time, and immunity has been developed to it. But the IgM titer indicates that the disease appeared in the body recently. So, these antibodies appear about 2 weeks after infection and gradually decrease within three months to normal values.

The natural struggle of the body

When the human body gets a parasite Toxoplasma gondii, the immune system can not remain indifferent. She recognizes an alien object and begins to develop special substances aimed at suppressing it. These are immunoglobulins, or antibodies. Each subspecies is susceptible only to one antigen, they recognize it and unite with it. Thus, immunity fights infection, and in the blood for a long time, and sometimes all of life, IgG antibodies to Toxoplasma gondii persist.

That is, the presence of these immunoglobulins only indicates that the body once had an infection, but at the moment remained immune to it. In principle, this is the answer to the question of what Toxoplasma gondii means in analyzes. Even if they are found during pregnancy, there is no point in panicking. Conversely, the presence of IgG antibodies and the absence of IgM indicate that the infection occurred a long time ago, and the future mother developed immunity. And this means that it will not be possible to re-become infected during the carrying out of the baby. Therefore, the child in such a situation, nothing is threatened.

Diagnosis of the disease

To determine whether there is anti Toxoplasma gondii in the body, it is possible with the help of a study of venous blood. This serological method is based on the fact that the presence of antibodies to infection is determined in the serum. For complex diagnosis, it is best to check all immunoglobulins for this disease. So, for example, the absence of Toxoplasma gondii lgG does not mean that the person is absolutely healthy. These antibodies are not produced immediately. In this case, it is important to determine whether the IgM titer is elevated. If this indicator is overestimated, the infection occurred just a few weeks ago. Since the first contact with the infection, no more than 3 months have passed. But if it is within normal limits, in combination with normal IgG indices, then the person most likely never had any toxoplasmosis.

Infection over the past 12 months can be evidenced by the fact that the serum contains antibodies of class G to toxoplasma in combination with IgM titers. But sometimes even this information is not enough. It is important for physicians to determine how strong the antibodies can bind to antigens. The earlier the organism met the infection, the higher this ability will be. These properties are associated with antigens, experts call avidity to toxoplasma.

At the same time, it is difficult to say exactly how much the level of antibodies should be, because different standards have been established in various laboratories. They are always displayed in the research results. Evaluate the results of the analysis should only be a doctor who will not only know how much the received data differ from the norm, but also understand what the titers IgG and IgM denote.

It is also important to be able to treat avidity to toxoplasma during pregnancy. If it is high and is more than 40% by the end of the first trimester, infection of the expectant mother during the bearing of the baby can be ruled out. But even low avidity does not mean that the infection has occurred recently. In this case, it is recommended to retake the analysis after a couple of weeks to determine how the indicators have changed. Based on this dynamics, it will be possible to draw definite conclusions about the prescription of infection.

Research of pregnant women

To exclude the possibility of intrauterine infection of crumbs, it is necessary to examine future mothers. This is usually done at the end of the first trimester. This period was chosen not accidentally, because the most dangerous is considered to be infection in the first three months. Even if the future mother gets infected later, it will not be so dangerous to the health of her crumbs.

But even if it was found that in a pregnant woman in the acute phase of toxoplasm, antibodies are found in the blood serum, this does not mean that she must necessarily have an abortion. Although in the first trimester, doctors, as a rule, insist on this procedure.

In addition to antibodies, avidity is determined. If all the results are disappointing, and everything indicates that the infection occurred after the conception of the baby, then it makes sense to investigate the amniotic fluid.

This is the most reliable method of determining whether there is a risk of intrauterine damage to the crumbs. If the prospective mother has an analysis for toxoplasmosis positive, and an elevated IgM antibody level has been determined, the doctor will recommend PCR diagnostics. To do this, make a puncture of the abdomen and gain amniotic fluid. It is examined by checking if there are DNA of Toxoplasma parasites in it. If the amniotic fluid is clean, then talk about the possible infection of the fetus does not make sense: the baby is healthy, even if the mother had antibodies to toxoplasma.

Alternative diagnostic methods

Rarely, with some forms of the disease, experts recommend, in addition to the blood test, and other studies. They are needed for accurate diagnosis of a variety of such a disease, as toxoplasm. Antibodies found can be in any of its types.

Estimate the extent of infection in the body can be using computer tomography or magnetic resonance imaging. These studies can identify foci of inflammation in the brain, if it is suspected that the infection affected this particular organ.

It is rare that a biopsy is used for an accurate diagnosis. This is an analysis in which a site of diseased tissue is taken and is studied in detail under a microscope.

Prevention of disease

Despite the fact that for people with normal immunity this disease is not terrible, it is important to know how to protect yourself from it. You need to remember about prevention, so you never know how toxoplasmosis develops. Symptoms in humans can be blurred, but in rare cases, the disease can lead to serious consequences.

One of the main precautions is limiting the contact with wild animals, especially birds and rodents. It is also important not to try raw meat, minced meat. Such products must be processed at a temperature of at least 77 degrees. When caring for cats that are masters for these parasites, it is advisable to avoid direct contact with their feces. After cleaning the toilet, you should wash your hands thoroughly. Usually these measures are enough to never know how toxoplasmosis can develop. Do not forget about personal hygiene - thorough washing of hands before and after the toilet, before and after cooking.

If you have cats at home, make sure that they do not touch your products, do not go to the tables. After all, in this case, you can not exclude the ingress of microorganisms from the area of the anus of the animal to your food.

Many consider it absolutely unnecessary to wash vegetables, fruits, berries and greens. In most cases people bought on the market are rinsed, but happy owners of household plots prefer to eat fruits directly from a bed or a tree. But you can not exclude that they could get an infection from birds or rodents.

Also do not forget that toxoplasmosis can be infected with unprotected sex. Therefore, it is preferable to use barrier methods of contraception during pregnancy. For this, both male and female condoms are suitable.

Treatment

Speaking about the need for therapy, many forget that in most cases it is only possible to identify the titre Toxoplasma gondii IgG (positive). And this means that the disease went unnoticed for the person himself. And only as a result of the research it was possible to reveal that the patient had already recovered, and he developed immunity. To treat the revealed antibodies IgG it is not necessary. Many people mistakenly believe that if the doctor does not prescribe medications for the detection of these immunoglobulins, he simply does not want to deal with them. This is absolutely wrong point of view. Such results are only evidence that the body has already overcome the infection and should not become infected anymore.

The need for treatment arises only in some cases, when an increased level of IgM antibodies is detected. So, therapy becomes obligatory for persons with weakened immunity. After all, the body is not able to produce enough antibodies to fight pathogens. Also, to prevent infection of the fetus, pregnant women, who have been diagnosed with an acute form of the disease, are also being treated. Particular attention is paid to babies who contracted in utero. Doctors do everything possible to prevent the development of complications in crumbs.

But before prescribing treatment, it is important to clarify which antibodies have been identified. Therapy is necessary only in cases where elevated IgM titers are detected, and this is displayed on the person's health. Therapy is carried out with the help of several antibacterial agents, selecting the most optimal treatment regimen.

If the disease has passed into a chronic form, then the drugs do not have the desired effect. In such situations, drug treatment is aimed, as a rule, to strengthen immunity.

To neutralize the acute phase, use a drug such as "Pirimetamine" (it is also available under the name "Daraprim"). It must be taken by a course chosen by the doctor. A specialist may recommend to drink tablets for 4 weeks continuously or do several approaches for 10 days. This drug is prescribed in combination with a drug such as "Sulfadiazin." As a rule, adults are recommended to take the drug "Pirimetamine" in a dosage of 25 mg, and "Sulfadiazine" - 1 g 2 times a day.

In addition to these funds, the drug "Clindamycin" can be prescribed. It is adopted in addition to those mentioned above.

Pregnant women who became infected after conception are prescribed a drug called Spiramycin. The effect of this drug is aimed at reducing the risk of vertical transmission of infection - from a sick mother to a fetus.

Eye lesions that arose due to intrauterine infection of the baby should be treated with glucocorticosteroids. For this, the drug "Prednisolone" can be used. It alleviates the condition with chorioretinitis.

If Toxoplasma gondii IgG is positive, then there is no point in treating the disease. Therapy should be aimed at alleviating the condition of the patient. But this is also necessary if the disease caused some damage to the nervous system, the brain, eyes, heart, lungs or other organs.