Toxoplasmosis in children

Toxoplasmosis in children is a congenital or acquired parasitic disease with a long, often chronic course, very frequent damage to the central nervous system, eyes, liver, spleen and other organs and systems.

Epidemiology

Toxoplasmosis in children is a zoonotic disease with pronounced natural focality. The disease is widespread among both humans and warm-blooded animals and birds. Among those infected, manifest forms of the disease are rare, accounting for no more than 1%. Toxoplasmosis pathogens have been found in more than 300 species of mammals and 150 species of birds. Toxoplasma is especially often found in domestic cats and some other representatives of the cat family (lynx, wild cats, jaguars, etc.). The disease in animals manifests itself as fever, diarrhea, CNS damage, abortion, but long-term asymptomatic carriage of toxoplasma is more often detected. Of particular epidemiological importance is given to cats, in whose body the sexual cycle of the pathogen's development occurs.

Humans become infected almost exclusively through food when eating raw or undercooked meat, and less often by contact (for example, when in contact with a cat). In rare cases, infection can occur through damaged skin. The possibility of transfusion transmission of toxoplasmosis is discussed. A person suffering from toxoplasmosis (like other intermediate hosts) is not dangerous to others. However, transplacental transmission of toxoplasma to the fetus from a woman carrying a newly acquired infection is possible. In chronic infection in women, transplacental transmission is unlikely. Susceptibility to toxoplasmosis reaches 100%, it is especially high in children. Most of all people who become ill with toxoplasmosis are children. In adults, toxoplasmosis often remains asymptomatic.

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Causes of toxoplasmosis in a child

The causative agent of the disease, Toxoplasma gondii, belongs to the class of sporozoans, the order of coccidia, the genus of toxoplasma - obligate intracellular parasites.

Toxoplasma resembles an orange slice or a crescent in shape. They are curved, one end is pointed, the other is more round, measuring (4-7) x (2-5) µm. When stained according to Romanovsky-Giemsa, the cytoplasm of the parasite is stained blue, and the nucleus is ruby-red.

Toxoplasmas are intracellular parasites (endozoites) capable of reproducing asexually (schizogony) in the cells of various tissues (liver, placenta, central nervous system, etc.) of many species of warm-blooded animals, including humans.

What causes toxoplasmosis?

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Symptoms of toxoplasmosis in a child

The incubation period lasts from 3 to 21 days, but can be extended to several months. The duration of the incubation period depends on the virulence of toxoplasma, the massiveness of infection and the premorbid background.

Toxoplasmosis in children usually begins acutely, with a rise in body temperature to 38-39 °C. Sometimes there are prodromal symptoms in the form of malaise, weakness, and a slight headache. In the acute development of the disease, children complain of general weakness, severe headache, sometimes chills, muscle and joint pain, refuse to eat, and lose weight. Some children develop rashes on the skin, usually maculopapular, they sometimes merge, forming spots with scalloped edges. The rash is distributed evenly over the entire body, but spares the scalp, palms, and soles. The lymph nodes increase in size, mainly the cervical, axillary, and inguinal, less often the lymph nodes of the abdominal cavity and mediastinum.

Symptoms of toxoplasmosis

Forms

Depending on the mechanism of infection, a distinction is made between acquired and congenital toxoplasmosis in children, which can manifest itself in mild, moderate and severe forms and have an acute or chronic course.

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Diagnostics of toxoplasmosis in a child

The diagnosis of toxoplasmosis in children is established on the basis of a comprehensive examination of the patient with mandatory examination of the fundus, ECG, EEG, CT, skull radiography, examination of the affected muscles, as well as the use of special research methods. Of the clinical symptoms, prolonged subfebrile temperature, lymphadenopathy, enlarged liver and spleen, eye damage and detection of calcifications in the brain are of diagnostic significance.

Diagnosis of toxoplasmosis

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Treatment of toxoplasmosis in a child

Toxoplasmosis in children is treated in a complex manner, including etiotropic, immunostimulating, pathogenetic and symptomatic agents.

Chloridin is used as an etiotropic treatment in combination with sulfonamide drugs (sulfadimezine, sulfapyridazine, bactrim, etc.). There are various treatment regimens. Etiotropic treatment is often carried out in cycles of 5-10 days with breaks between them of 7-10 days in combination with probiotics (atsipol, etc.). Usually 3 cycles are carried out, which is 1 course. Medicines are given in an age-appropriate dose in 4 doses. To prevent the side effects of chloridin, multivitamins and folic acid are prescribed. In case of contraindications to the use of chloridin (diseases of the hematopoietic organs, kidneys, etc.), treatment is carried out with delagyl, trichopolum, aminoquinol.

Treatment of toxoplasmosis

Prevention

To prevent toxoplasmosis, it is important to improve natural foci, treat domestic animals, limit contact with cats, observe personal hygiene rules, and heat-treat food products, especially meat. It is important to prevent contamination of soil in children's playgrounds and sandboxes with cat excrement. Domestic cats should not be fed raw meat. It is recommended to examine children for toxoplasmosis and treat them if they become ill.

How to prevent toxoplasmosis?

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