Toxoplasmosis in adults. Symptoms and treatment for pregnancy, drugs, folk remedies. How is diagnostics, how to cure

Toxoplasmosis - the most common parasitic disease in Russia. From 15 to 70% of the population are either carriers or those suffering from toxoplasmosis. Most exposed to the disease group - adults over 40 years, and leading unhygienic lifestyle people.

Susceptibility to the parasite is observed in almost every human being. The symptoms and treatment determined by the degree and form of progressive parasite in the body.

What is toxoplasmosis

Toxoplasmosis - a parasitic infection of the body that a person receives from the animal or due to lack of hygiene and a healthy lifestyle. A bacterium that enters the gastrointestinal tract, which starts its vital functions in the body, called Toxoplasma.

It is divided into several stages of development of bacteria:

• oocysts (eggs);
• cysts (pupae);
• tachyzoites (adults).

  

The first stage of Toxoplasma enters the intestine of cats through contact with birds and rats. Yard cats are carriers, and rarely suffer acute. Eggs through feces bacteria are released into the environment, in soil, in the sandbox where children play, and so on.

The adult human body proliferate in the tissues of various organs, causing systemic damage. Pregnant transmit the disease to the fetus, causing the child (if he survived) is congenital toxoplasmosis.

tachyzoites

Tachyzoites - is independent organisms Toxoplasma, which enter the body of warm-blooded and people. Through the bloodstream, they travel to various organs, mainly muscle, including the heart. Tachyzoites are able to penetrate through the tissue of the intestinal wall and other organs.

organisms reproduction period lasts 6-8 hours - this is a very rapid process for the bacteria. Capturing a certain area of ​​tissue parasites destroy surrounding cells, as they are able to destroy the phagocytic cells are those cells that are responsible for immunity. That is, the tachyzoites affect the immune system, inclusive.

In addition to muscle and heart, settle tachyzoites in the brain and nerve tissue, destroying the surrounding cells, causing A number of different diseases such as encephalitis, cerebral arachnoiditis, various mental disorders and Other.

tissue cysts

This form of Toxoplasma is formed from the eggs enter the body the bacteria. Tissue cysts - this is the incubation period of the disease, ie canned form of the disease, which, under the influence of a favorable environment in the body is activated, releasing bradyzoites, growing into tachyzoites.

In human cells cysts fall through uncooked meat or poorly roasted meat pigs, sheep and rabbits. Immunity to the full, can not cope with the microorganisms, and they are distributed throughout the body, causing granuloma and calcification.

Cysts settle in the cells of various tissues: in the eyes, brain, heart, etc., and all this time they can live intact (unsolved) throughout the life of the owner. During his stay in the cells live and reproduce, destroying the cell. When the cell bursts, located outside the already formed tachyzoites. Print the cysts are very difficult, they do not react to many antibiotics.

oocytes

Oocytes - a product of sexual reproduction or bespolovogo tachyzoites. They enter the body cat with an infected bird or mouse, begin to multiply in the gut it, and faeces fall into the ground or water.

Man bathing in dirty water, or by eating unwashed vegetables from the garden with the ground, which were oocytes infected himself. In humans, they are also justified in the intestine, and through the intestinal wall, enter the bloodstream, infecting other organs.

By themselves, the oocytes were not able to penetrate through the intestinal wall. Once in the body, they start to give off spores (sporozoites), which penetrate the tissue cells, multiply there, creating tachyzoites.

Methods Toxoplasma infection

Toxoplasmosis in adults (symptoms and treatment depend on the stage of the disease) develops due to Toxoplasma enters the body by the following factors:

Oral (through food)	eating infected meat products that have not undergone heat treatment or it does not last until the end; when cooking meat may hit the raw meat particles in products (minced sample to salt, etc.); the use of herbs, vegetables collected from soil, which contained Toxoplasma eggs (oocytes) are not heat-treated; drinking unboiled water, not boiling took place, which contained oocytes.
Percutaneously (through the skin)	penetration of oocytes by dirty hands, which touched the contaminated soil or sand, wherein defecated cat wearing bacterium; swimming in dirty waters and rates, where they can bathe cats and livestock, bearing the parasite.
Transplacentally (after organ transplantation)	through the plasma (fetus); during organ transplant, especially the heart.
Gematransfuzionno	through blood transfusions.

The development of the disease

Once in the body of the parasite, toxoplasmosis develops in several stages, which are characterized by their symptoms, and spread of the bacteria throughout the body.

1. The initial phase (incubation period). The duration of the period depends on the source of contamination. The acquisition of the parasite from cat - 5 days, through food - from 10 to 23 days. Cyst or oocyte getting into the intestine, allocates bradyzoites or sporozoites. There they begin to multiply and grow into adult bacteria tachyzoites. Recent eat tissue cells, causing necrosis.
2. generalization phase. Passing from primary infected foci tachyzoites enter the lymph nodes. Through them pass into the lymph, then getting into the blood. With the blood of bacteria through the blood vessels to the liver and heart. When pumping heart blood, the parasite spreads to other organs. HIV infected patients, in this case, become ill sepsis. At this stage affects the brain, endocrine, eye.
3. persistence phase. At this stage the bacterium is no longer replicates, and in the affected tissues around tahizotov formed impermeable envelope antibodies. This shell is tissue cysts with bradyzoites. The immune system, thus, remains infected.

Symptoms of congenital toxoplasmosis

Toxoplasmosis in adults, symptoms and treatment of which depends on the residence time of the parasite in tissues, can be transmitted to children in the womb. If a pregnant woman becomes infected with toxoplasmosis for the first time, that is, the risk of transmission to the fetus.

But it's not always the case. Not all pregnant women transmit the disease to infants only when the bacterium was struck by placental tissue. In the absence of such a focus, an analysis for toxoplasmosis in a child will be negative.

Pass the parasite baby woman can only 1 times in life. At the same time, it is very important at what period it was at the time of infection. This factor determines the further stage of the disease with which the child is born.

If the infection occurred in the early stages, the newborn will be born with the subacute stage, in the later stages - acute stage. Infection during the first weeks of pregnancy can lead to miscarriage.

There are 3 stages percolation congenital toxoplasmosis, each characterized by their own set of complications and disorders arising due to tissue destruction

In the acute stage of the disease in the newborn there are the following diseases:

• hepatosplenomegaly;
• jaundice;
• pneumonia with respiratory failure;
• cyanosis;
• encephalitis;
• Various swelling.

Subacute step congenital toxoplasmosis accompanied with the following diseases:

• hydrocephalus;
• inflamed ocular vessels;
• deposition of calcium salts in tissue;
• convulsions.

In the chronic phase of toxoplasmosis the following effects may occur in neonates:

• seizures, epilepsy-like, but do not belong to it;
• dementia;
• endocrine disruptors.

At all stages of inflammation of the blood vessels back of the eye can be observed, because the parasite is localized in newborns there. The remaining effects can be immediately, but after a few years after the birth.

Symptoms of acquired toxoplasmosis in adults

In adults, symptoms of toxoplasmosis is accompanied by a mild and patients recover on their ownExcept in cases of pregnancy, HIV and AIDS infected - these patients assigned mandatory treatment.

There are several forms of the disease, which are accompanied by a variety of symptoms, depending on the complications that have arisen as a result of the defeat of various organs. Allocate acute, chronic and latent form.

The acute form

The acute form of the disease is diagnosed very rarely get sick and it is mainly people with reduced immunity.

Accompanied by this kind of a variety of symptoms, which range from the form of the disease, of which there are four basic types:

• eye;
• cerebral;
• visceral;
• limfoadenopaticheskaya.

Ocular form causes eye diseases, in particular chorioretinitis, which is a form of uveitis. More often than not, this form is observed as a late symptom of congenital toxoplasmosis, which is manifested either up to 30 years, or never. When acquired toxoplasmosis eye shape is typical for patients after 40 years. This type is characterized by frequent relapses.

Cerebral form accompanied by various diseases of the brain, namely, encephalitis, encephalomyelitis and arachnoiditis.

At the same time, the symptoms can manifest themselves in the form of:

• rash;
• heat;
• inflammation of lymph nodes;
• mental disorders;
• sweating;
• headaches;
• seizures;
• fainting;
• dizziness;
• hemiparesis;
• cerebellar lesions;
• skin diseases.

Visceral form is characterized by systemic complications, passing in the following diseases:

• bronchitis;
• hepatitis;
• myocarditis (usually);
• pneumonia;
• inflammation of the small intestine and colon.

Limfoadenopaticheskaya form - the most common. As it affects the lymph nodes, it is often confused with mononucleosis and lymphatic tuberculosis.

Symptoms of this type of toxoplasmosis include:

• swollen lymph nodes;
• apathy;
• headache;
• muscle pain;
• body temperature 37 ° -37,5 °, which does not pass weeks or months.

The chronic form

Also, a rare form of the disease, which occurs due to not fully withdrawn cysts. From time to time, cysts release bradyzoites and the disease recurs. At this time, the patient has a prolonged fever that does not go for weeks, months or years. It also reduces the ability to work, there is a permanent weakness in the body.

Other symptoms that characterize chronic form, are as follows:

• headache;
• insomnia;
• nervousness;
• cardiac abnormalities (tachycardia, cardiac left shift, changes in the myocardium, etc.);
• recurrent pain in the joints;
• increase in liver and lymph nodes;
• decreased vision, due to the acquired uevita;
• violation of the hypothalamus;
• the formation of calcifications in the brain;
• pneumonia;
• gastritis;
• zhelchevyvedeniya failures in the system.

In this form of toxoplasmosis not affected individual bodies and there is a variety of systemic disorders.

latent form

This form occurs most often in the fetus. In adults, creeping form of toxoplasmosis is also found, but only through laboratory studies, since it has no obvious symptoms.

Tissue cysts are not recognized by the immune system as long as it will allocate bradizioty. This form is dangerous because it tends to have mutations of the parasite from one species to another. Struggling with this form only AIDS patients who are being treated for toxoplasmosis life.

diagnosis of toxoplasmosis

Toxoplasmosis in adults, symptoms and treatment of which depends directly on the form of the disease, to diagnose extremely hard. This is due to the fact that the disease has a lot of options for the development and is associated with numerous symptoms that are characteristic of many diseases.

It is also necessary to distinguish between the carrier of the parasite and the disease itself. Thus, using laboratory techniques, instrumentation, as well as differential diagnosis, by which should be deleted following diseases having similar characteristics:

• diseases affecting various lymph nodes (Hodgkin's disease, measles, listeriosis, Brucellosis, etc.);
• zooantroponoznye infection;
• tuberculosis;
• genital infections;
• herpes;
• cytomegaly et al.

Upon detection of a patient following manifestations, there is reason to believe that he was also sick with toxoplasmosis:

• generalized lymphadenopathy;
• long low-grade fever;
• myalgia;
• polyarthralgia;
• enlarged liver and spleen.

Laboratory research

A crucial role in the study of toxoplasmosis play laboratory studies. Using PCR and IEF tests determine presence sticks in blood, its DNA and waste residues.

For detection of antibodies to Toxoplasma ELISA serological tests used or rarely RNIF which often gives a false positive result. These assays were performed to patients falling into a risk group, such as pregnant women, patients with immunodeficiency.

Let us consider each of them:

• Polymer Chain Reaction (PCR) It is performed to detect blood, cerebrospinal fluid, and materials obtained by biopsy of human DNA of the parasite. Using test determining stage of disease activity at the acute forms of the disease and congenital toxoplasmosis. Pregnancy was conducted. It is performed in conjunction with serological tests.
• Reaction immunofluorescence (RIF) It performed through a fluorescence microscope, which defines the special glow in the blood, cerebrospinal fluid, biopsy and other materials that contain the antigen.
• Linked immunosorbent assay (ELISA) determines the existence of IgM and IgG antibodies to Toxoplasma in blood samples. This is the first test that detects the presence of the parasite and the infection period after it occurs a number of other studies. As an independent research is not carried out, only in combination with other tests established diagnosis.
• Reaction indirect fluorescence (RNIF) also determines the toxoplasma antibodies, and allows them titration.

diagnostics

Diagnostics of toxoplasmosis is not carried out. She only needed to determine the level of organ damage.

The patient may be given the passage of such studies:

• lumbar puncture (suspected meningitis);
• Radiography of the head and the lungs (for suspected pneumonia, tuberculosis, cerebellar lesion, presence kaltsifikantov in the brain);
• US GI;
• CT / MRI (suspected meningitis and encephalitis);
• ECG.

Treatment of toxoplasmosis drugs

The main method of treatment of toxoplasmosis is pyrimethamine appointment, sometimes in combination with sulfonamides and antibiotics.

Doses and treatment are determined depending on the form of the disease, its severity, duration and patient groups. Total 1 course antiprotozoal therapy, in which, first introduced pyrimethamine 1 times a day for 75 mg. Then, the dose is reduced to 25 mg once a day for the next 3 days.

The treatment regimen was added sulfanilamide at a dose of 500 mg four times a day for 7 days. If the last drug contraindications, it is replaced with a mixture of pyrimethamine with clindamycin also within 7 days of 450 mg 4 times a day.

However, for the whole period was added calcium folinate or co-trimoxazole. Further adding to treatment of other drugs depends on the affected organs.

Treatment of severe forms of toxoplasmosis in adults

Toxoplasmosis in adults treated by the standard form indicated above, plus the introduction of drugs that eliminate common symptoms. If the disease in the acute stage has passed, causing chorioretinitis or CNS, in the course of treatment is added glucocorticoid. If necessary, it also includes receiving antisense drugs.

Other additional drugs include:

• diclofenac;
• meloxicam;
• nimesumed;
• vitamin C;
• azoximer bromide;
• prednisolone.

The patient can lead a multidisciplinary team, watching for the treatment of damaged organs.

The patient is undergoing tests at:

• neurologist;
• ophthalmologist;
• rheumatologist;
• gynecologist-obstetrician;
• cardiologist.

Hospitalization is performed only in acute manifestations of the disease in the chronic form (especially in lesions of the CNS), and pregnant women regardless of the stage of the disease.

Features of treatment of acute toxoplasmosis in pregnant women

According to statistics, one third of women of childbearing age in Russia is infected with toxoplasmosis in one form or another. 1% of the total number of pregnant women gain during pregnancy is a bacterium, in this case, 30-40% of them pass the disease to children.

Pregnant women are being treated on an outpatient basis or in the obstetric and gynecological hospital no earlier than 12-16 weeks of pregnancy. Monitoring the course of the disease occurs 1 time in two months. Treatment includes receiving a standard course of pyrimethamine with sulfonamides and antibiotics. Also included receiving antihistamines, immunostimulants, vitamins and pathogenic agents.

the list of drugs approved for pregnant women:

• pyrimethamine;
• sulfanilamide;
• trimethoprim;
• spiramycin.

antibiotics:

• methacycline;
• lincomycin;
• erythromycin.

Chronic toxoplasmosis in pregnant women treated before or after pregnancy, and it is not an indication for abortion, as the risk of fetal infection is not present.

Treatment of chronic forms of toxoplasmosis

Chronic toxoplasmosis is treated during periods of activation of the disease. Tactics selected depending on concomitant diseases caused by Toxoplasma. Treatment is directed at eliminating chorioretinitis symptoms, CNS disorders, sexual organs and other acquired complications. Chronic patients tested 2 times a year.

In practice, the treatment is applied chronics 5-7 day course of chemotherapy, administration of drugs that suppress the body's response to the parasite, for example:

• diphenhydramine;
• pipolfen;
• suprastin;
• corticosteroids.

Immunotherapy is also used toksoplazminom and ultraviolet irradiation.

Specific immunotherapy toksoplazminom

Toksoplazminom therapy is administered to chronic patients. It was revealed that a similar course in 90% of patients gives stable remission, the remaining percentage of patients did not respond to this treatment.

The preparation consists of a set of antigens on tokspoplazmu, which is found under the skin in different dosage, increasing the number of injections from 3 to 10 per day. This, in effect, an immune modulator, causing the body to produce the necessary antibodies to fight the parasite.

Studies have not shown any side effects to such treatment in chronic patients. 4 weeks after the start of the course, the patients returned the ability to work and socialization, as well as cease progressing disease that touches organ system. The chronic form is passed into latent.

Folk remedies for toxoplasmosis

Toxoplasmosis in adults (symptoms and treatment of established professionals) to a greater extent on their own cures. If the disease is mild, the presence of the parasite in the cells can be derived using the traditional methods of struggle with a variety of worms and other bacteria infected in everyday life can each.

The diet of each person must be pumpkin seeds and garlic in any quantity. It has long been known that garlic is aggressively opposed to all sorts of parasites. Use it can be both raw and cooked, if you feel a burning sensation in the stomach of fresh garlic.

It is also effective to cook the garlic with milk and take it within 10 days. Other folk remedies include various herbal teas and tinctures.

Prepare one of these concoctions the following recipe:

• 1 tbsp. l. tansy, watches and trifoliate centaury pour 1 liter of boiling water;
• Pour the mixture into a thermos bottle and push day;
• use 100 g before breakfast, before lunch, 300 g and 200 g before bedtime.

The following recipe is from a larger number of herbs:

• 100 g of camomile;
• 50 g of gentian root;
• 100 g Tansy;
• 120 g buckthorn bark;
• 50 g of wormwood.

All this is to insist in a thermos 1 night and in the morning, before breakfast drink 200 g of the mixture on an empty stomach.

prognosis

Weather favorable for the majority of people suffering mild. With proper treatment of acute forms also can be treated. Only a poor prognosis for patients with AIDS and HIV - such patients are not cured until the end and have to be seen by a doctor and undergo periodic treatment to the end of life.

For pregnant women who were infected in the early stages, there is a risk of miscarriage or abnormalities in the child's development. The longer the pregnancy at infection, the easier it will be the consequences for the fetus.

For patients with congenital toxoplasmosis form relatively favorable prognosis, unless there are clear violations mental retardation, a person can live life as a carrier or have the disease in the latent form.

Toxoplasmosis in adults to treat all stages of the disease. The main time to recognize the symptoms and make treatment. To prevent recurrence, to avoid the source of infection, maintain a healthy lifestyle and hygiene.

Registration of the article: Mila Friedan

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