Toxoplasmosis in children
Last reviewed: 23.04.2024
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Toxoplasmosis in children is a congenital or acquired parasitic disease with a long, often chronic course, a very frequent lesion of the central nervous system, eyes, liver, spleen and other organs and systems.
Epidemiology
Toxoplasmosis in children refers to zooantroponosis with a pronounced natural foci. The disease is widespread both among humans and among warm-blooded animals and birds. Among the infected, the manifest forms of the disease are rare, amounting to no more than 1%. Pathogens of toxoplasmosis are found in more than 300 species of mammals and 150 species of birds. Especially often, toxoplasma is found in domestic cats and some other members of the cat family (lynx, wild cats, jaguars, etc.). The disease in animals is manifested by fever, diarrhea, CNS damage, abortion, but more often they show a prolonged asymptomatic carriage of toxoplasm. Special epidemiological significance is given to cats, in the organism of which the sexual cycle of development of the pathogen occurs.
Human infection occurs almost exclusively through nutritional methods when using raw or insufficiently thermally processed meat, more rarely by contact (for example, by contact with a cat). In rare cases, it is possible to infect through damaged skin. Discuss the possibility of transfusion transmission of toxoplasmosis. A person suffering from toxoplasmosis (like other intermediate hosts) is not dangerous to others. However, a transplacental transmission of toxoplasm to the fetus from a woman carrying a freshly acquired infection is possible. With chronic infection in women, transplacental transmission is unlikely. Susceptibility to toxoplasmosis reaches 100%, it is especially high in children. Most of all cases of toxoplasmosis are children. In adults, toxoplasmosis often remains asymptomatic.
Causes of the toxoplasmosis in the child
The causative agent of the disease - Toxoplasma gondii - belongs to the class of sporoviks, the order of coccidia, the genus of toxoplasm - obligate intracellular parasites.
In the form of toxoplasma reminiscent of the orange slice or crescent moon. They are bent, one end is pointed, the other is more round in size (4-7) x (2-5) μm. When painting according to Romanovsky-Giemsa, the parasite is dyed blue, and the nucleus is ruby-red.
Toxoplasma - intracellular parasites (endozoites) that can reproduce asexually (schizogony) in cells of various tissues (liver, placenta, CNS, etc.) of many species of warm-blooded animals, as well as humans.
Symptoms of the toxoplasmosis in the child
The incubation period lasts from 3 to 21 days, but may extend to several months. The duration of the incubation period depends on the virulence of toxoplasm, the massiveness of infection and the premorbid background.
Toxoplasmosis in children usually begins acutely, with an increase in body temperature to 38-39 ° C. Sometimes there are prodromal phenomena in the form of malaise, weakness, minor headache. With acute development of the disease, children complain of general weakness, severe headache, sometimes cognition, muscle and joint pain, refuse to eat, lose weight. Some children develop rashes on the skin, usually spotty-papular, they sometimes merge, forming spots with scalloped edges. The rash settles evenly throughout the body, but spares the scalp, palms and soles. Lymph nodes, mainly cervical, axillary and inguinal, rarely lymph nodes of the abdominal cavity and mediastinum are enlarged.
Diagnostics of the toxoplasmosis in the child
Diagnosis of toxoplasmosis in children is established on the basis of a comprehensive examination of the patient with mandatory examination of the fundus, removal of the ECG, EEG, CT, radiography of the skull, examination of the affected muscles, and using special research methods. Of the clinical symptoms of diagnostic significance have a long subfebrile condition, lymphadenopathy, enlarged liver and spleen, eye damage and the detection of calcifications in the brain.
How to examine?
What tests are needed?
Treatment of the toxoplasmosis in the child
Toxoplasmosis in children is treated cosmetically with the inclusion of etiotropic, immunostimulating, pathogenetic and symptomatic agents.
As an etiotropic treatment, chloride is used in combination with sulfanilamide preparations (sulfadimezine, sulfapyridazine, bactrim, etc.). There are various treatment regimens. Etiotropic treatment is often performed in cycles of 5-10 days with intermissions between them 7-10 days in combination with probiotics (acipol, etc.). Usually spend 3 cycles, which is 1 course. Medicinal products are given in an age-appropriate dose of 4 doses. To prevent side effects of chloridine, multivitamins and folic acid are prescribed. With contraindications to the use of chloridine (disease of the hematopoietic organs, kidneys, etc.), treatment is carried out with delagil, trichopolum, aminoquinol.
Prevention
For the prevention of toxoplasmosis, recovery of natural foci, treatment of domestic animals, restriction of contact with cats, observance of personal hygiene rules, heat treatment of food products, especially meat, are of great importance. It is important not to allow soil contamination on children's playgrounds, in sandboxes by stool cats. Domestic cats can not be fed raw meat. It is recommended to test for toxoplasmosis in children and in case of illness to treat.
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