What is Toxoplasmosis?

Toxoplasmosis, also known as toxoplasmosis, is a zoonotic disease caused by Toxoplasma gondii. It is widely parasitic on nucleated cells in humans and animals. Recessive infections are common in humans; the clinical manifestations of patients are complicated, and their symptoms and signs lack specificity, which easily leads to misdiagnosis and mainly invades the eyes, brain, heart, liver and lymph nodes. Toxoplasma gondii is one of the important pathogens of embryo deformity caused by intrauterine infection during pregnancy. The disease is also closely related to AIDS.

Basic Information

nickname: Toxoplasmosis
English name: toxoplasmosis
Visiting department: Infectious Diseases

Multiple groups: Cancer, immunodeficiency, congenital defect and other patients
Common locations: Eyes, brain, heart, liver, lymph nodes
Common causes: Caused by Toxoplasma gondii infection
Common symptoms: High fever, maculopapular rash, myalgia, joint pain, headache, etc.

Causes of Toxoplasmosis

It is caused by Toxoplasma gondii and has a global epidemic. Special populations such as cancer patients, immunosuppressed or immunodeficiency patients, and infants with congenital defects have a higher infection rate.

Clinical manifestations of toxoplasmosis

Generally divided into two types of congenital and acquired acquired, are more common in recessive infection. Most of the clinical symptoms are caused by recent acute infection or activation of potential lesions.

The clinical manifestations of congenital toxoplasmosis are complex. Most babies are asymptomatic at birth, and some of them develop retinochoroiditis, strabismus, blindness, epilepsy, psychomotor or mental retardation in the months or years after birth. The clinical manifestations of the following different combinations: retinal choroiditis, hydrocephalus, microcephaly, anencephaly, intracranial calcification, etc. should be considered in this disease.

Acquired toxoplasmosis is of different severity, and hosts with normal immune function can show the most common acute lymphadenitis, accounting for about 90%. Immunodeficiency patients such as AIDS, organ transplants, malignant tumors (mainly Hodgkin's disease, etc.) often have significant systemic symptoms such as high fever, maculopapular rash, myalgia, joint pain, headache, vomiting, delirium, and encephalitis, myocarditis , Pneumonia, hepatitis, gastroenteritis, etc.

Toxoplasmosis ocularis is mostly congenital, and what you see the day after tomorrow may be caused by the activity of the underlying potential lesion. Clinically, there are blurred vision, blind spots, photophobia, pain, tear overflow, central vision loss, etc., and few systemic symptoms. Vision improves after inflammation subsides, but often does not fully recover. May have vitreous opacity.

Toxoplasmosis test

Etiological examination

Tissues or body fluids of suspected sick or dead animals are smeared, compressed or sliced, fixed in methanol, and examined by Wright or Ji's staining microscopy to find toxoplasma gondii or cysts.

2. Detection of specific nucleic acids by PCR

3. Serological diagnosis

Indirect fluorescent antibody test, indirect hemagglutination inhibition test, enzyme-linked immunosorbent assay and complement binding test detect specific IgM, IgG, IgA antibodies or serum circulating antigens.

Toxoplasmosis diagnosis

1. With clinical symptoms and characteristics.

2. Exclude other diseases that are confused with it.

3. Etiology positive.

4. Detection of two specific positive IgM, IgG, IgA antibodies.

Toxoplasmosis treatment

Most of the drugs used to treat this disease have a strong effect on trophozoites, and may have a certain effect on the encapsulation of azithromycin and atorvaquinone, and the rest are not effective.

1. Normal immune function:

Scheme 1: Combination of sulfadiazine and pyrimethamine.

Option 2: Acetylspiramycin: Orally three times a day

Option 3: Azithromycin: Dayton. Can be combined with sulfa drugs (used as before).

Scheme 4: Clindamycin: Orally three times a day. Can be combined with sulfa drugs (used as before).

2. Immunocompromised patients: the above-mentioned various medication schemes can be used, but the treatment course should be prolonged, and -interferon can be added at the same time.

3. Pregnant women can use acetylspiramycin (or clindamycin or azithromycin).

4. Newborns can use spiramycin (or pyrimethamine) + sulfadiazine, or azithromycin.

5. Toxoplasmosis in the eye is available, sulfa drugs + pyrimidine (or spiramycin): the course of treatment is at least one month; clindamycin: 4 times a day, at least for 3 weeks. If the lesion involves retinal plaque and optic nerve head, short-range adrenocortical hormone can be added.

Toxoplasmosis prognosis

The prognosis of the disease is related to the virulence of the worm and the susceptibility of the infected person.

The congenital prognosis of this disease is more serious, and the mortality rate of untreated cases is about 12%. The most common sequelae are retinochoroiditis, followed by intracerebral calcification, mental disorders, hydrocephalus, cerebellar malformations, and convulsions.

If the disease is acquired in time, the prognosis is better. Symptoms of moderate acute acquisition, such as untreated, lymphadenopathy, can persist for several months, but usually resolve without adverse effects. Specific treatment can shorten the course of the disease. When multiple organs are violated, there are particularly cases of immunosuppression, with serious consequences.

Toxoplasmosis prevention

1. Check before and during pregnancy.

2. Domestic cats are best fed with dry feed and cooked food. Regularly clean the cat's nest, but pregnant women should not participate in cleaning.

3. Both low temperature (-13 ) and high temperature (67 ) can kill Toxoplasma gondii in meat.

4. Wash hands, cutting boards, knives, etc., and items that have come in contact with raw meat with soap and water.

5. Wash vegetables thoroughly before eating.

6. Improve the medical personnel and animal husbandry and veterinary personnel's understanding of the disease and master the diagnosis and treatment of the disease. Investigate the infection of people and animals, especially livestock, and related factors in order to develop practical control measures.

7. Do a good job of changing two pipes and five parts of water and feces. Pay special attention to preventing cat feces that may have toxoplasma oocysts from contaminating water sources, food and feed.