Toxoplasmosis in children treatment. Congenital toxoplasmosis. Types of treatment for toxoplasmosis

How symptoms manifest in children, in what forms the pathology proceeds, in what ways it is transmitted and how to treat, we will consider in more detail in the form of step-by-step instructions in this article.

Symptoms of toxoplasmosis in children

The severity of symptoms directly depends on the immune status of the child's body. The incubation period is 3 days-3 weeks.

The disease begins with a sudden appearance:

• headache;
• weakness, malaise;
• loss of appetite;
• concentration disorders;
• chills, fever;
• drowsiness;
• weight loss;
• rashes on the body;
• enlargement of the lymph nodes.

In severe cases of the disease, there is:

• vomit;
• convulsions;
• paralysis of the limbs;
• coma.

Symptoms may be single or combined with multiple foci in the brain.

General symptoms

The disease is especially dangerous for infants under 1 year old and immunocompromised patients. Pathologies immediately from the first moments proceed rapidly.

General symptoms:

• fever;
• the appearance of a hemorrhagic rash on the body;
• lack of appetite;
• weakness;
• dizziness;
• enlargement of the liver and spleen in size;
• nausea in the morning.

Symptomatically, toxoplasmosis manifests itself in the same way as typhoid fever. This is a dangerous disease and, if left untreated, can lead to serious complications, including death.

Toxoplasmosis in newborns: symptoms

The disease in newborns begins with an acute course. If unusual signs appear, you should urgently contact a pediatrician or call an ambulance.

The main symptoms in infants are easy to recognize:

• loss of appetite, refusal to breastfeed;
• lethargy, capriciousness, tearfulness;
• chills, fever up to +39 gr;
• signs of intoxication, vomiting, diarrhea;
• sudden weight loss;
• papular rash on the body;
• a pronounced increase in the lymph nodes in the armpits;
• convulsions;
• signs of paralysis;
• squeezing with legs, squeezing to the tummy;
• impaired coordination of movements.

Attention! The disease in the acute stage proceeds rapidly. With the appearance of convulsions, cyanosis on the face, signs of suffocation, you should urgently consult a doctor.

latent form

Toxoplasmosis has a 3-stage course, proceeds:

• in latent form. It is with her that the disease begins;
• acute;
• chronic form.

Symptoms of intrauterine infection of a child at birth may be absent, and only tests can reveal this form of the disease. Ultrasound, CT will indicate disorders in the central nervous system, signs of cerebral palsy of the extremities.

acute form

Toxoplasmosis in the acute stage proceeds rapidly and the symptoms in children are clearly expressed:

• severe intoxication;
• weakness;
• temperature rise to high values;
• headache;
• decreased concentration;
• rash on the body;
• limb numbness.

Children with immunodeficiency are especially hard to endure the acute course. In case of damage to internal organs, the condition can become extremely severe and dangerous.

Chronic form

Toxoplasmosis in the chronic relapsing stage proceeds sluggishly.

Symptoms are absent or minor:

• headache;
• temperature rise to 37.5-38gr;
• dull pain in the heart;
• capriciousness, lethargy;
• sleep disturbance;
• lack of appetite;
• weight loss even with a normal diet.

During the diagnosis, multiple lesions of the central nervous system, deviations in mental, mental, and physical development are revealed. Epilepsy, deafness or blindness may develop.

Causes of the disease

It is unformed immunity that often causes infection of children in the womb, when the body is not able to resist toxoplasma.

Infection is possible in three ways:

• transplacental or through the placenta with intrauterine infection, which leads to rapid death of the embryo or the development of serious anomalies;
• alimentary through poorly cooked, fried raw meat, infected poultry or food with cat excrement getting into them;
• contact in case of infection of children after contact with an infected cat (dog).

Parents need to be vigilant and attentive towards children. Limit contacts of babies with stray animals, teach them to wash their hands from an early age and not put dirty objects into their mouths, especially on the street.

The main sources of infection

Carriers of toxoplasmosis: birds and animals that excrete calculi into the ground or sandboxes where children play. It is this source of infection that is the most common when babies do not wash their hands after the street, put dirty objects into their mouths, or have been in contact with stray infected cats and dogs.

Intermediate sources of infection:

• pigs, sheep, cows, chickens, rabbits, goats, in whose brain cells Toxoplasma cysts can coexist almost throughout the life of their owner;
• infected patients after contact with them;
• blood transfusion.

It is cats and dogs that most often become the intermediate host of Toxoplasma and may well enter the human body.

Treatment should begin immediately! Protect yourself and your loved ones!

Congenital toxoplasmosis

A congenital disease is transmitted to children through the mother's placenta during intrauterine infection. If it is detected at the beginning of pregnancy, then a miscarriage is possible or the doctors will suggest an abortion to the woman.

Danger of congenital infection

The danger of congenital toxoplasmosis in the consequences:

• abnormal malformations in the development of vital systems, organs and tissues in the fetus;
• damage to the heart, blood vessels, brain. It can lead to death in the first days of a child's birth.

The danger of toxoplasmosis depending on the semester of pregnancy:

After birth, it appears:

• delayed mental and physical development;
• hemorrhagic rash on the body;
• enlargement of the spleen and liver;
• inflammation of the lymph nodes in the armpits;
• development of chorioretinitis or inflammation of the retina;
• strabismus;
• deafness;
• thrombocytopenia;
• anemia;
• neurological abnormalities;
• cerebral palsy against the background of weakened immunity.

We have 2 dogs and a cat at home, we regularly carry out preventive measures against infection with helminths. We really like the remedy, because it is completely natural, and this is important for prevention."

Acquired toxoplasmosis

Acquired toxoplasmosis is less dangerous than congenital. Today it is being treated quite successfully. If left untreated, the disease will become chronic, and babies who have been ill once will suffer symptoms from time to time. As a rule, they are less pronounced and proceed sluggishly.

Diagnosis of toxoplasmosis

If a newborn child has at least some unpleasant signs, then it is better not to postpone visiting a doctor for a comprehensive diagnosis, examination of all systems: nervous, visual, auditory.

Basic diagnostic methods:

• puncture, sampling of material from the cerebrospinal fluid;
• punctate of lymph nodes to identify the type of pathogen;
• a brain biopsy by taking brain tissue for examination;
• MRI of the brain;
• samples and tests from blood serum, when a fourfold increase in cyst titers is observed with toxoplasmosis;
• ultrasonography for an increase in the ventricles, indirectly indicating infection with toxoplasma;
• immunofluorescence for titers indicating infection of newborns immediately after birth at 1, 2, 3 weeks.

Disease prevention

In kindergartens and schools, adults need to constantly carry out sanitary and educational work, teach children to observe simple hygiene and prevention measures.

Pregnant women, in order to avoid the risk of infection with Toxoplasma, it is important to constantly conduct tests and not neglect the tests prescribed by the attending physician.

Prevention for children is:

• compliance with personal hygiene standards;
• washing hands, also vegetables and fruits before eating;
• limiting contact with street cats, dogs.

For prevention purposes, doctors often prescribe Spiramycin, Rovamycin, sulfonamides (1 g per day), calcium folinate (treatment course - 3 weeks) to pregnant women to prevent possible infection with Toxoplasma.

Treatment of toxoplasmosis in children

If a blood test revealed the need for drug treatment to suppress the causative agent of the disease.

Mainly:

• antibiotics (Pyrimethamine, Sulfadiazine, Clindamycin, Spiramycin, Dalacin, Clarithromycin);
• dietary supplements, immunostimulating drugs to strengthen the immune system.

Treatment is supervised by a doctor. It is possible to prescribe joint groups of drugs, for example, tetracycline and penicillin groups.

In a chronic course, it is prescribed: Dalacin, Clindamycin as antibiotics designed to destroy Toxoplasma cysts in tissues. Treatment - stationary under the supervision of doctors.

Especially dangerous is a fresh infection during pregnancy, when you can no longer do without a course of chemotherapy. Many drugs are extremely contraindicated for women, especially in the first trimester of pregnancy and can lead to deformities, teratogenic effects on the fetus.

The doctor will look at the situation, suggest an abortion or prescribe:

• antibiotics (Spiramycin, Clindamycin, Clarithromycin, Azithromycin);
• glucocorticoids.

Symptomatic treatment

Symptoms of toxoplasmosis can be different, so the doctor, when developing treatment, will take into account the pronounced manifestations of the disease. If there are deviations from the central nervous system, then the patient will be redirected to a neurologist, if there are vision problems, to an ophthalmologist, or a gastroenterologist with severe nausea, vomiting, diarrhea.

Can the disease recur?

Toxoplasma in both adults and children can stay in the body for decades, located in the shell of the sclera of the eyes, brain, deep tissues of internal organs.

As a rule, children who have had an infection earlier develop stable immunity. Rarely, Toxoplasma cysts can settle in organs and systems, the liver, kidneys, and spleen.

Under the influence of provoking factors, begin their reproduction again and lead to damage to the brain and eyes. Treatment is specific and based on the results of the tests.

If the primary disease is not treated, then the transition from the acute stage to the chronic one is inevitable. But this should not be allowed, especially in babies, also treated with folk remedies and herbs. In case of suspicious symptoms, it is better to immediately contact a specialist. This is important for pregnant women, especially in the early stages of the first trimester.

Toxoplasmosis leads to sad consequences in children with intrauterine infection. Do not avoid deviations immediately after birth: deviations of the central nervous system, motor skills, psyche. Toddlers are doomed to a lag in mental physical development, practically to disability for life.

That is why it is so important for women to plan pregnancy, treat other chronic diseases in a timely manner and not refuse to undergo a full examination in the first stages after conception.

The number of antibodies in the population correlates with age (an increase of 0.8% per year).

In Central European women, approximately 30% have antibodies by the age of 20, and 50% by the age of 40.

The primary infection (of the mother) is usually asymptomatic or mild (like an influenza infection with swollen lymph nodes).

The risk of infection of the fetus depends on the gestational age at which the disease occurred in the mother:

• In the first trimester, the risk is approximately 15%.
• In the second trimester, "about 45%.
• In the third trimester 70%.

Cats are the main and intermediate hosts. They (usually young) within 2-4 weeks after the onset of their primary infection, they excrete a large number of oocytes with their droppings.

A person becomes infected when eating raw or undercooked meat (eg salami, smoked sausage), as well as while working in the garden.

Symptoms and signs in children

Approximately 80% of infected newborns have no symptoms of infection at birth. Mental retardation, visual impairment, or learning disabilities often do not become noticeable until months or years later.

Symptomatic infection is characterized by the classic triad:

• Encephalitis with intracerebral foci of calcification, hydrocephalus and convulsions.
• Chorioretinitis: may recur after several months or years.
• Hepatomegaly (sometimes with jaundice) is a classic symptom.

Nonspecific symptoms are frequent: malnutrition, jaundice, the child sucks weakly, generalized convulsions.

Severe course: at birth, the child has a maculopapular rash, generalized lymphadenopathy, thrombocytopenia and hepatomegaly.

Sometimes intrauterine fetal death occurs.

Diagnosis in the mother

Screening for toxoplasmosis: mandatory in early pregnancy (according to the recommendations of the Maternity Welfare Society, necessary in case of reasonable suspicion of infection). If the result is negative, the test must be repeated after 8-12 weeks. Tips for pregnant women on prevention, see below!

The diagnosis of toxoplasmosis is established serologically. In doubtful cases - clarification in the control laboratory.

Quantitative analyzes are: the Sebin-Feldman reaction, the indirect immunofluorescence test and the hemagglutination test.

Determination of IgM using ELISA and immunosorbent agglutination test (ISAGA).

After 10-14 days from the onset of the primary infection, IgG and IgM appear to antigens of tachyzoites, and later - bradyzoites.

If IgG are detected in early pregnancy, then an IgM test is necessary. If the test is negative, no further diagnosis is required.

A four-fold increase in the titer in one of the tests for IgG or IgM (or a significant increase) indicates a fresh infection in a pregnant woman (if necessary, consultation with a control laboratory).

IgM in toxoplasmosis can persist for years. Only about every tenth detection of IgM in a pregnant woman indicates the presence of a fresh infection in her.

Additional studies (only for special questions): indirect haemagglutination test, IgA test, avidity test and immunoblot test (reference laboratory!).

IgA are detected 1-3 weeks later. Approximately 3-8 weeks after the onset of infection, the titer or concentration of IgA reaches a maximum.

Diagnosis in a child

Confirmed primary infection in a pregnant woman: specific IgM and IgA can be detected in fetal blood with 22 ng. However, in fetal infection, IgM is detected only in 40% of cases. A more reliable diagnostic method is the detection of Toxoplasma by PCR in amniotic fluid or fetal blood.

After the birth of a potentially infected baby:

• Assessment of clinical status (hepatosplenomegaly, etc.).
• Neurological examination, neurosonography. In the presence of indications - lumbar puncture with the determination of the concentration of protein, glucose, the number of cells with their typing, PCR of cerebrospinal fluid for toxoplasma.
• Ophthalmological examination to rule out chorioretinitis.
• Hearing assessment using the OAE + BERA method.
• Serological examination to determine IgG, IgM and IgA; Sebin-Feldman reaction. In case of positive results, additional studies: IgG avidity test, mother/child IgG profile comparison.
• Detection of toxoplasma in cord blood, placental tissue, umbilical cord, cerebrospinal fluid by PCR, or sometimes by infecting mice with biological material.

Serological follow-up tests are performed every 6 to 8 weeks (eg before each baby check-up) until maternal IgG is gone. Sometimes this period lasts more than 12 months.

Evidence of prenatal infection and indication for treatment are:

• clinical symptoms
• serological data.

Attention: all the results of laboratory diagnosis of prenatal toxoplasmosis must be submitted without indicating the surname.

Treatment in children

If you suspect or verify fresh toxoplasmosis in a pregnant woman:

• starting treatment immediately reduces the risk of fetal infection by 50% if treatment is started less than 4 weeks after the onset of infection.
• Until the end of 15 NB spiramycin 3.0 g / day for 2-4 injections (6 million units = 8 coated tablets for 2-4 injections). The teratogenic effect of spiramycin is not described, it accumulates in the placenta.
• C 16 NB - therapy for 4 weeks: sulfadiazine 50 mg / kg / day (up to 4 g) orally for 4 injections and pyrimethamine 50 mg on the first day, 25 mg per injection on subsequent days + folic acid (lederfolate) 10- 15 mg/day orally.
• Weekly monitoring of the blood picture in order to assess hematopoiesis.
• If you are allergic to sulfadiazine - replace it with spiramycin.

For any suspicion of an infection in a newborn:

• if therapy was not carried out during pregnancy, start treatment, even if the infection is asymptomatic or subclinical.
• If the primary infection has been consistently treated during pregnancy and the newborn has no clinical signs of toxoplasmosis, the initiation of therapy can be delayed until the infection situation in the child is finally clarified.
• Clindamycin can be used as an alternative drug for allergic reactions, reaching high concentrations in the eye with chorioretinitis.
• With chorioretinitis and encephalitis with a high concentration of protein in the cerebrospinal fluid (> 1 g / l), additional prednisolone 2 mg / kg / day until the active inflammation disappears.
• Control of treatment: blood picture, during therapy with sulfonamides, also control of urine (crystalluria, hematuria).

Important: In infected children during therapy, there is also a drop in antibody titer (decrease in the level of antibodies received from the mother and suppression of the immune response by the child's body against the background of treatment). After cessation of therapy, the antibody titer rises again.

Prevention in children

Prevention: The most important preventive measures during pregnancy are:

Refusal to eat raw or semi-cooked meat and sausages (eg, salami, smoked sausage).

When gardening, wear gloves; when preparing meat or before eating, wash your hands thoroughly.

Cat care and cat litter cleaning by others.

Notice: During the infection, the mother can breastfeed the baby.

Course and prognosis in children

Course and prognosis: even with a seemingly asymptomatic course of the disease in a newborn child, a recurrence of chorioretinitis is possible later, after several months or years. This is also possible in the first year of a child's life and during sequential treatment → therefore, regular monitoring by an ophthalmologist is necessary.

During its life cycle, Toxoplasma takes various forms - bradyzoites, tachyzoites and sporozoites. The former are slowly increasing organisms contained in tissue cysts. Most often they are located in the muscles and brain. Bradyzoites do not respond to antibiotics. This form of Toxoplasma can remain in the host's body throughout his life.

Tachyzoites are responsible for acute infection and tissue destruction. They quickly divide and spread throughout the body. The increase in their number continues until the formation of cysts or destruction of the host cell. After that, free tachyzoites move further and resume rapid reproduction.

Ways of infection

Toxoplasmosis in children occurs as a result of accidental ingestion of infected cysts. Another option is congenital transmission to the fetus from the mother during pregnancy. Ingestion of infected cysts can occur in one of the following cases:

Cats excrete the pathogen in their feces for several weeks after infection. Toxoplasmosis is contracted when they eat infected rodents. Feces become dangerous when a cyst matures in it. This occurs after 2-3 days in a temperate climate and longer in a cold one. Thus, the risk of infection is minimized by cleaning the pet's toilet every day.

Congenital toxoplasmosis in children is a specific form of the disease in which the fetus is infected through the placenta. The disease is very dangerous, it leads to fetal death and abortion, and toxoplasmosis in newborns is associated with neurological and neurocognitive disorders and chorioretinitis. A simple blood test during the first prenatal visit to a specialist will help determine if a woman has been exposed to Toxoplasma. If she first meets her after conception, the fetus is at very high risk.

Signs of illness

In children, toxoplasmosis sometimes does not even make itself felt. If symptoms of infection become apparent, they vary with age and immune response to the infection.

congenital infection

When infected with toxoplasmosis during pregnancy, a woman must be treated. Otherwise, she can pass the infection to the developing child in the womb. Children infected in the first trimester tend to have the most severe symptoms.

A woman who becomes infected before conception is unlikely to pass on toxoplasmosis to her baby. The fact is that she and, therefore, the child will develop immunity to the disease. A pregnant woman can develop toxoplasmosis again if she has previously been exposed to the pathogen and her immune system is weakened. A reasonable approach is to wait at least 6 months after infection before conception.

In 90% of children born with the disease, there are no signs of toxoplasmosis at first, but in many the symptoms become apparent after a few years. In infants born prematurely or with low birth weight, manifestations occur immediately or shortly after birth.

Symptoms of toxoplasmosis in children are as follows:

• Increase in body temperature.
• Swollen lymph nodes.
• Jaundice.
• Unusually large or small head size.
• Eruptions on the skin.
• Bruising or bruising.
• Anemia.
• Enlargement of the spleen or liver.

Some newborns with toxoplasmosis may have problems with the nervous system, leading to seizures, increased muscle tone, malnutrition, hearing loss, and developmental delays.

In addition, the risk of damage to the retina is increased, which leads to severe visual impairment, up to its loss. If a congenital infection is not treated during infancy, toxoplasmosis will manifest itself in early or even adolescence. The most common symptom is eye damage.

Acquired infection

In healthy children with toxoplasmosis, symptoms are most often absent. Perhaps the signs of the disease will be limited to an increase and soreness of the cervical lymph nodes. Most children, even in this case, do not require treatment, unless the condition worsens.

In immunocompromised children, for example due to AIDS, cancer, organ transplant therapy, the infection is very severe. In them, it affects the nervous system, leading to the development of toxoplasmic encephalitis. This is an inflammation of the brain, which is accompanied by the following manifestations:

• Fever.
• Seizures.
• Headache.
• Psychosis.
• Problems with vision, speech, movement, thinking.

In healthy children, mild symptoms (swollen lymph nodes) usually go away on their own after a few months, even if left untreated. Congenital toxoplasmosis in almost all cases leads to irreversible visual impairment or developmental delay. In a child with a weak immune system, the infection can be fatal.

Diagnostics

Toxoplasmosis can be detected by laboratory tests of blood, cerebrospinal fluid, amniotic fluid, placenta, or other tissues. The enzyme immunoassay method is considered the most informative. This test measures the levels of antibodies produced by the body's defense system to attack harmful protozoa.

Genetic tests help identify DNA-containing Toxoplasma genes. This analysis is used to examine the amniotic fluid for the presence of a disease in the fetus. Another method of prenatal diagnosis is ultrasound. But these tests are not completely accurate and sometimes give false positive results, indicating that there is toxoplasmosis, although in fact it is not.

When examining babies, doctors ask mothers questions about pets, sources of contaminated food or water. The examination includes the study of the condition of the eyes, ears, nervous system, analysis of cerebrospinal fluid and the search for changes in the brain using imaging methods.

Treatment

The fight against infection is carried out only with a strong severity of symptoms. Treatment is recommended for children with weak immunity, because their disease is very difficult and can lead to death. If there are no health problems, the body will develop immunity on its own.

Treatment of congenital disease is carried out with various combinations of antitoxoplasmic drugs, usually within 1 year after birth. The doctor chooses the medication and the duration of the course individually. Treatment of toxoplasmosis in children who are otherwise healthy is carried out for 4-6 weeks. Children with weakened immune systems have to be hospitalized. Children with HIV or AIDS will be forced to take antitoxoplasmic drugs throughout their lives.

Prevention

Toxoplasmosis in children can be prevented. To do this, it is necessary to observe preventive measures related to the care of pets, cooking and personal hygiene. To avoid infection with Toxoplasma, you must follow the following rules:

• Boil and fry the meat well.
• Wash your hands with soap and water after handling raw meat or dirty vegetables.
• Wash any fruits and vegetables before serving.
• If you buy fresh meat, freeze it for a few days before cooking.
• Thoroughly wash all utensils, boards and surfaces in the kitchen.
• Close the sandbox to prevent cats from using it as a toilet.
• Wear gloves in the garden and garden.
• Fight cockroaches and flies - they carry pieces of feces on their paws.
• Drink only purified boiled water, especially when traveling to tropical countries.

If you have a cat living in your house, try not to let it go outside. Change the contents of the tray every day. It is better for a pregnant woman to refrain from doing this and ask someone to take care of the cat litter. In addition, it is not recommended to take a new animal into the house during this period.

Toxoplasmosis is an infection with the protozoan Toxoplasma. Its main owner is cats (domestic and wild), and in the human body, immunity is quickly developed to it. And although it does not completely destroy the pathogen, the symptoms of toxoplasmosis in children are most often absent. With active immunity, Toxoplasma "bricks" into a cyst and does not harm the health of a child infected after birth. But it should be borne in mind that the pathogen is deadly during intrauterine infection, as well as for children with immunodeficiency.

The difference between the main and intermediate carriers of toxoplasmosis is that the pathogen goes through a full cycle of sexual reproduction in the intestines of the host. And in the intestines of the carrier, it cannot reproduce sexually - only asexually, allowing the formation not of adults, but of cysts with larvae enclosed inside them. Such cysts enter the bloodstream and are carried with it to the soft tissues of the body of the intermediate carrier, however, they are almost not released into the external environment and are not transmitted to others.

Toxoplasmosis in a child or an adult is just one of the latter. Large and small, Russian and African cats, if they are infected with Toxoplasma, can transmit it to humans and other animals, but a human carrier cannot.

Transmission routes

Adults and children can catch the infection through contact not so much with the pet itself, but with the contents of its tray, the sandbox in the yard, and other places where cat waste products are most often found. And from there, Toxoplasma enters the soil and water.

But the main source of infection with toxoplasmosis, both for the cats themselves and for people, is the poorly processed meat of an already infected animal - chicken and pork, beef, rabbit meat. There are also isolated cases of transmission of Toxoplasma during blood transfusion and organ transplantation. The very same way of infection is observed standard - through the mouth, into which cysts / live pathogens enter along with:

• poorly fried or boiled meat;
• contaminated fingers;
• unwashed vegetables and fruits "straight from the garden";
• unboiled water;
• foreign objects that children so love to try “on the tooth”.

Also, infection with Toxoplasma during pregnancy can lead to transmission of infection from the mother to the fetus through the placental route.

Types of disease

However, for asymptomatic carriage and the course of toxoplasmosis, an adult or child must have a normally developed (maximum, with slight signs of weakening) immunity. And it can be significantly reduced due to:

• taking immunosuppressants- with allergies or other autoimmune processes like psoriasis;
• HIV infection- especially if he threatens to go into the stage of AIDS;
• radiation exposure- accidental or intentional, as in the treatment of cancer;
• herpes virus infection- any of its four varieties, since they all have the properties of strong immunosuppressive agents.

In such cases, it is no longer worth counting on an imperceptible course of infection. And it is important for parents of babies with significantly depressed immunity to know in advance how toxoplasmosis manifests itself in children.

Since infection with them can occur both before and after the birth of the crumbs, there are congenital and acquired types of toxoplasmosis, as well as its acute and chronic stages. The picture of the symptoms observed in the patient also depends on them.

If everything is in order with the immune defense of the baby’s body, the symptoms may not appear at all or disappear over the next few weeks (on their own or with medical support). Against toxoplasmosis, effective immunity is developed for life. Therefore, it is possible to get sick again only with the development of immunodeficiency states.

Symptoms of toxoplasmosis in children

Signs of toxoplasmosis in a child under one year old, if he was born healthy, is a rare phenomenon, indicating extremely low hygiene standards adopted in the family where he was born. We are talking about the age when the baby himself could hardly come into contact with the animal or its excrement. And so, one of the parents transferred the infection from them to the child - the one who first stroked the cat or cleaned her tray, and then went to swaddle / feed the baby without washing his hands. In any case, toxoplasmosis in very young or immunocompromised children manifests itself:

• rise in temperature- for up to several weeks, but usually not higher than 37.5°C;
• aching, aching pain in the joints and muscles- not only when moving, but also at rest;
• enlargement of the liver and spleen- sometimes in combination with swelling of the lymph nodes throughout the body;
• headache - mainly due to temperature;
• chills - also as a result of elevated body temperature;
• rash - all over the body with the exception of the hands, feet and scalp under the hair;
• signs of damage to internal organs- depending on which of them were affected.

In a child, various organs are involved in the process, as a result of which it can be observed:

• pneumonia;
• heart rhythm disturbances;
• kidney failure;
• symptoms of meningitis/meningoencephalitis.

Among the latter, convulsions, stiffness of the neck muscles (forced tilted head position), delirium, paresis of the limbs, and a painful reaction to light and sound are most common.

Thus, the answer to the question of how dangerous toxoplasmosis is for a newborn child is even a simple enumeration of its possible symptoms. Toxoplasma cysts can get from the intestines to any organ through the bloodstream. That is why he does not have specific signs. And it is necessary to differentiate toxoplasmosis with many other diseases, sometimes even non-infectious ones.

Diagnostics

Diagnosis of toxoplasmosis in children under one year old and older is difficult because cysts must be looked for in body tissues, and they can be found in the blood, cerebrospinal fluid or lymph only by chance. The most informative of all types of research on toxoplasmosis is a blood test for immunoglobulins - universal antibodies of blood and cell membranes that are effective against viruses and protozoa. This analysis has several important features.

• Repeat studies. An increase in the titer (concentration) of immunoglobulins occurs already from the second week after infection with toxoplasmosis, and the maximum of their presence is reached in a period of up to six months. Therefore, the analysis is taken repeatedly, each time with a break of two to three weeks.
• Mother check. If intrauterine infection of the fetus is suspected, the blood is also examined for antibodies to toxoplasmosis in the mother.
• Interpretation of results. Immune proteins on the surface of cell membranes are of different types, and their purpose is also different. If IgM are “quick response” proteins, then IgG provide the body with resistance to the pathogen. Thus, their proportion also allows us to draw certain conclusions about the timing of the presence of Toxoplasma in the body. The presence of a high and, especially, a growing IgM titer means that no more than a year has passed since the infection. And the presence of only IgG indicates the presence of stable immunity to infection.

It is important to establish at least the approximate timing of infection and the current stage of development of immunity to Toxoplasma if we are talking about a child still in the womb. The fact is that toxoplasmosis is really dangerous only for two categories of people:

• suffering from severe immunodeficiency;
• infected during fetal development.

And for those, and for others, it is lethal with a probability above 90%. And if the patient can be saved, mental retardation or blindness awaits him. Other systemic disorders are also likely, which greatly worsen the prognosis of the quality of life. Therefore, infection with toxoplasmosis less than a year before pregnancy or after its onset is almost the only situation in which this pathogen can pose a threat to life (in this case, the fetus).

Therapy

Treatment of toxoplasmosis in children is carried out with the help of powerful intracellular antibiotics that can even destroy cysts - that is, a form that is resistant to any external influences, in which the larvae of the pathogen are protected from the external environment by a protective shell. In fact, we are talking about chemotherapeutic drugs used in cancer therapy.

Reviews of doctors about the results of treating toxoplasmosis with their help are more often positive, but only in terms of how successfully they managed to cope with the infection itself. It is problematic to assess the number and extent of side effects in this case, because when it comes to choosing between life and death, the limits of permissible harm from taking a drug can be expanded almost indefinitely. In other less acute situations (erased or zero symptoms, lack of immune problems, age over six years), they try to avoid their appointment. The following agents are used to treat toxoplasmosis.

• "Delagil". An antimalarial drug based on the active ingredient chloroquine.
• "Fansidar". The only one in this group indicated for the treatment of children under the age of seven years. Its basis is sulfadoxine and pyrimethamine. This drug is well suited to replace Delagil, but is incompatible with it when taken simultaneously.
• "Rovamycin". "Heavy", but effective intracellular antibiotic based on spiromycin. The manufacturer of the drug categorically does not recommend it for use in children. However, it does not have a toxic effect on the fetus when the mother is treated for toxoplasmosis during pregnancy, since it does not cross the placenta.

Standard Method

The standard treatment regimen for toxoplasmosis in children involves the appointment of one main drug and several auxiliary ones. The latter are designed to compensate for the side effects of the main agent and provide additional effects, for example, immunostimulating, restorative effects. Among them are vitamins, the same immunoglobulins, digestive enzymes. For the treatment of toxoplasmosis with intracellular antibiotics, there are a number of mandatory precautions.

• It should not be used unless absolutely necessary. Because the likelihood of disability or death due to side effects caused by toxoplasmosis drugs is also high in children.
• Their unauthorized use is unacceptable. That is, they should never be used at home without a doctor's prescription. The reason is the same - likely lethal complications if misused or overdosed.
• Pregnancy with toxoplasmosis is more reasonable to interrupt. Since infection of the unborn child with toxoplasmosis leads to malformations incompatible with life, in most cases, the pregnancy itself ends in a miscarriage. But even if it can be saved, the newborn either dies within the next few weeks, or remains disabled. In any case, toxoplasmosis affects the child so detrimentally that the attending physician has the right to recommend an abortion to the patient.

As for the treatment of toxoplasmosis with folk remedies, it is permissible only with mild, almost absent symptoms of pathology. This infection is so resistant to attempts to destroy it that it is not always amenable to the action of even intracellular antibiotics - in fact, the same poisons, only with a slightly more selective effect. Therefore, talking about the possibility of treating toxoplasmosis with decoctions of plants, prayers, conspiracies is at least naive.

Possible Complications

The consequences of toxoplasmosis in children who suffered it after birth in mild / moderate severity are absent. And in children and adults at risk (immune deficiency or prenatal development), toxoplasmosis most often ends in death. In the case of survival, patients in almost 100% of cases develop:

• oligophrenia - of varying severity;
• microphthalmia (underdeveloped organs of vision)- in case of intrauterine infection;
• blindness - resulting from atrophy of the optic nerve with acquired toxoplasmosis.

Other disorders are possible in the form of hydrocephalus (overflow of the ventricles of the brain with CSF), prolonged jaundice, followed by a transition to cirrhosis of the liver, complete (less often) or partial (more often) paralysis of the limbs.

Thus, toxoplasmosis in a child is easier to prevent than to cure. It is 100% a "dirty hands" disease because it has only one carrier. Under such conditions, standard food and household hygiene guarantees against toxoplasmosis. And when it is strengthened with additional measures, the chances of contracting Toxoplasma during pregnancy or in the first few years of a baby’s life tend to zero even if there are several pets.

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The disease is caused by the simplest microorganism - Toxoplasma gondii, which exists in three forms:

1. cysts. Once in the human body, they create a protective shell for themselves, which allows them not to leave the host for many years.
2. Trophozoites. They multiply inside animal cells; in tissues they can be found at the acute stage of the disease.
3. Oocysts. They are found in the mucosa of the small intestine of animals and are excreted in the feces. In the external environment, they can persist for more than a year; it is this form of Toxoplasma that transmits infection from an animal to a child, for example, when playing in a sandbox.

Danger of congenital infection

Toxoplasmosis is not dangerous for healthy adults and is usually mild. But congenital toxoplasmosis, associated with intrauterine infection of the fetus from an infected mother, poses a terrible threat to the child, even death. How the disease will proceed from the child:

• Infection of the fetus in the first trimester at the last stage of embryonic development most often leads to spontaneous miscarriage or the child is born with developmental defects incompatible with life.
• When infected in the middle stages of pregnancy, the acute period of the disease can end in utero, and then the child is born with defects in the connective tissue of the internal organs, eyes and brain.
• When infected at the end of pregnancy, the child can be born healthy, and the acute period of the disease occurs after childbirth.

Congenital toxoplasmosis leads to severe consequences in newborns. Therefore, for women who have had this disease in the 1st and 2nd trimesters of pregnancy, doctors offer an abortion.

How does infection occur?

Occurs when:

• Tactile contact with the feces of infected animals, when playing in the park, in the country, in the sandbox.
• Testing raw or insufficiently thermally processed meat, raw eggs;
• Eating unwashed vegetables and fruits with residues of earth particles on them with toxoplasma cysts;
• Through the blood of an infected person (such cases are very rare);
• From an infected mother in utero.

Types and forms of toxoplasmosis in a child

There are 2 types of toxoplasmosis, depending on how it is transmitted:

1. Congenital. When a baby becomes infected through the placenta or during childbirth.
2. Acquired. Infection occurs after birth during life.

Forms of toxoplasmosis are determined by the intensity of its symptoms:

• latent toxoplasmosis - the predominant form of the course of the disease, in which the carrier does not feel symptoms;
• acute toxoplasmosis - has a pronounced manifestation;
• chronic toxoplasmosis - alternating periods of exacerbation and remission.

• lymphonodular (lymph nodes);
• meningoencephalitic (brain);
• eye;
• cardiac, generalized.

How to recognize toxoplasmosis: symptoms in children

In newborns and children of the first year of life, due to weak immunity, the following signs of infection are noted:

• enlargement of the spleen and liver;
• hepatitis A;
• convulsions;
• excessive accumulation of fluid in the brain (dropsy or hydrocephalus).

Toxoplasmosis of newborns is often accompanied by malformations of the central nervous system, vision and hearing, liver dysfunction, myocarditis, intradermal hemorrhages. The child is lethargic, sucks poorly, loses weight or, on the contrary, sleeps very restlessly.

The incubation period of the disease ranges from 3 to 21 days. In the future, toxoplasmosis in children is accompanied by the following symptoms:

• lethargy, headaches, general malaise;
• temperature rise to 38-39 degrees;
• sensation of pain in muscles and joints;
• loss of appetite, and as a result, a decrease or very slow weight gain;
• rash in the form of papules all over the body (except for the palms, feet and skin under the hair on the head);
• swollen lymph nodes under the armpits, on the neck and in the groin.

Toxoplasmosis has pronounced symptoms in a child in the acute phase.

latent form

acute form

The acute form of the disease develops rapidly and is characterized by severe intoxication, weakness, changes in internal organs and the nervous system. The acute form proceeds like typhus, the temperature rises, the spleen and liver increase in size, headaches, convulsions, paralysis, and vomiting appear.

Chronic form

Toxoplasmosis in the chronic form is characterized by fever, headache, damage to the eyes, nervous system. These children are characterized by delayed mental and physical development, epilepsy syndrome, blindness, deafness.

Diagnostics

At the stage of pregnancy, the expectant mother takes a serological blood test to exclude possible pathologies, including toxoplasmosis.

In newborns, two tests are taken if toxoplasmosis is suspected:

1. Immunofluorescence.
2. Sabin-Feldman trial.

What is dangerous toxoplasmosis: the consequences of the disease

The consequences of toxoplasmosis depend on the form of its course. The most severe of them occur during intrauterine infection and in people with HIV. In the latter case, a vicious circle occurs - weak immunity, which, when infected with toxoplasmosis, decreases even more.

Toxoplasmosis in newborns causes further developmental delay, late teething, paralysis, speech disorders, severe eye disease, deafness, damage to the cardiovascular, musculoskeletal and circulatory systems.

People who have had the disease in a latent form, as a rule, do not know about it and do not feel any consequences, as well as symptoms. Those who have suffered toxoplasmosis in acute or chronic form feel its consequences depending on the affected organs. Severe diseases of all body systems are possible, as well as serious complications in the eyes, up to blindness.

How is toxoplasmosis treated in children?

Toxoplasmosis in children is treated with medication and folk remedies. We describe the most effective methods.

Medical treatment in children

If pathogens are accidentally found in the analyzes, but there are no symptoms of the disease, then the treatment of toxoplasmosis in children is not carried out. The body itself will cope with the infection and develop immunity. If there are symptoms, drugs are prescribed.

Pregnant women with toxoplasma and no symptoms should not be treated. In the presence of a chronic form of the disease, doctors will treat the woman through prophylactic immunotherapy. In case of infection during pregnancy, which poses the greatest danger, courses of chemotherapy are carried out starting from the second trimester. The main drugs for the treatment of pregnant women and newborns are sulfadiazine and pyrimethamine.

Folk methods for children

Traditional medicine recipes cannot replace medicines in the treatment of toxoplasmosis, they are auxiliary.

1. Infusions of medicinal herbs: calendula flowers, eucalyptus leaves, elecampane root. To prepare a spoonful of crushed plants, pour a glass of boiling water and let it brew. Take three times a day for a tablespoon.
2. Bird cherry. 4 tablespoons of plant branches are poured with two cups of boiling water and boiled over low heat for 15 minutes. The decoction is filtered and taken in the same way as herbs.
3. Garlic. The decoction is prepared from several of its cloves and a glass of boiling water. Drink in small sips throughout the day.
4. Pumpkin seeds are recommended to be eaten with the film, as much as possible. Can be ground into powder using a food processor.

Questions

Is toxoplasmosis contagious?

Can the disease recur?

How to prevent disease?

Prevention of toxoplasmosis is, first of all, hygiene. Its rules are as follows:

• thorough hand washing after contact with the ground, playing in the sandbox, cleaning the cat litter box;
• timely examination of pets for the presence of toxoplasmosis;
• careful temperature treatment of meat and eggs;
• washing vegetables and fruits;
• timely cleaning of the cat litter;
• caring for increasing the immune forces of the body.

Which doctors should be contacted?

First of all, you should consult with your pediatrician. He will examine the child and prescribe a general blood test. If the fears are confirmed, then the treatment is carried out by an infectious disease specialist. In case of neurological disorders, they are observed by a neurologist. In the maternity hospital, the examination is carried out by a neonatologist.

Can a baby get toxoplasmosis while breastfeeding?

If the nursing mother is healthy or is in a state of latent toxoplasmosis, then infection of the child during breastfeeding is excluded. With the active form of the disease, infection of a newborn is possible in very rare cases if a woman has bleeding cracks or wounds on her nipples.

Can a person, in particular a child, get any diseases from a guinea pig?

Guinea pigs can carry toxoplasmosis, but the rodent species does not shed oocysts. Guinea pigs are not usually eaten, which means that it is impossible to get infected from them.