Congenital toxoplasmosis. Symptoms of toxoplasmosis in a child and its treatment Toxoplasmosis symptoms in a 3-year-old child

The younger the child, the higher the likelihood of an infectious agent entering the body. The manifestations of the disease are extremely variable - from asymptomatic carriage to severe and even fatal forms. Toxoplasmosis can be transmitted not only through direct contact with animals, but also through consumption of contaminated meat that has not been subjected to the required temperature. You can become infected even when choosing meat products at the market. Toxoplasma can enter the human blood directly through scrapes and cuts on the skin or insect bites.

If you have pets in the house that often walk outside, the likelihood of getting sick increases many times, especially in children. Toxoplasma can enter the body after contact with the ground, cat litter, or pet excrement.

Symptoms

The incubation period of the disease in children ranges from several days to three weeks. The duration of the incubation phase depends on the aggressiveness of microorganisms, the degree of infection and the presence of factors in the patient that accompany the development of invasion. The higher the immune status of the child’s body, the longer the incubation period and the less pronounced the symptoms of the disease will be.

The acute form of the disease begins suddenly, although sometimes prodromal manifestations are observed in the form of general malaise, weakness, and moderate headache. Babies become fussy and lose their appetite. Attention is impaired in children of preschool and school age.

The main symptoms of acute toxoplasmosis are:

• temperature up to 39 o C;
• severe headaches;
• chills and fever;
• pain in the limbs (signs of general intoxication of the body);
• loss of appetite;
• weight loss;
• rash in the form of spots and papules: later the rashes merge into large areas on the skin;
• enlarged lymph nodes (usually the jaw, cervical, axillary and inguinal nodes are affected).

Acute toxoplasmosis in children is almost always accompanied by a rash that is evenly distributed throughout the body, excluding the head, inner parts of the palms and soles. Itching is usually not observed, but irritation may occur. In some cases, damage to the organs of vision is possible - strabismus, clouding of the lens of the eye, diplopia (double vision).

Sometimes the symptoms are more severe: vomiting, convulsions, possible paralysis and falling into a coma. Sometimes single or multiple lesions (abscesses) develop in the brain. The spleen and liver enlarge. External manifestations of the disease may resemble typhus or encephalitis. Against the background of Toxoplasma infection, bacterial infections such as pneumonia and bronchitis can develop. Possible disorders of consciousness, memory loss, lethargy, persistent coordination disorders.

In patients with immunodeficiency diseases, toxoplasmosis can cause the most severe complications, including death.

Congenital toxoplasmosis

In the congenital form of the disease, damage to systems, organs and tissues is very extensive. Possible congenital pathologies of the visual organs (including complete blindness), malformations of the brain and spinal cord and other severe lesions. The severity of congenital pathologies directly depends on the age of the embryo: the younger it is, the more severe the disease is.

The fetus can die inside the mother's body as a result of abnormalities that are incompatible with life. If the child survives, then after birth he immediately develops symptoms of acute toxoplasmosis:

• intoxication;
• jaundice due to liver damage;
• swollen lymph nodes;
• damage to the central nervous system - encephalomyelitis.

Pregnant women can be infected by pathogenic microorganisms only once: in subsequent pregnancies, the fetus will be reliably protected by antibodies produced in the mother’s body.

Basic principles of toxoplasmosis therapy

If children and adolescents have strong immunity and the virulence of microorganisms is low, the disease can occur without any symptoms. The only symptoms in such cases are enlarged lymph nodes and periodic low-grade fever up to 37-37.5 o C. Some doctors do not carry out specific therapy in such cases: only dynamic observation and restorative treatment with vitamins and immunostimulating drugs are prescribed.

If previously it was impossible to cure congenital toxoplasmosis, today it is possible to achieve not only stabilization of the disease, but also its total elimination. Residual symptoms and manifestations may persist if irreversible damage to the central nervous system occurs.

Treatment of the chronic variant of the disease is much more complex than the treatment of acute toxoplasmosis, since chemical drugs do not have a pronounced effect on the causative agents of toxoplasmosis. Immunomodulatory and hyposensitizing therapy and treatment with vitamin preparations are of decisive importance.

Prevention

Ways to prevent Toxoplasma infection in children:

• careful personal hygiene after contact with animals, playing outside;
• eating only fully cooked meat;
• compliance with sanitary rules for keeping animals, including timely cleaning of toilets and observation by a veterinarian;
• examination of pregnant women for toxoplasmosis.

During pregnancy, women should avoid contact with cats and dogs, especially outdoor ones. If antibodies to the causative agents of toxoplasmosis are detected (if women are pregnant for the first time), the question of treating the disease or terminating the pregnancy is raised.

Toxoplasmosis belongs to the group of diseases that have a natural focality and is characterized by a fairly wide range of hosts. Toxoplasmosis affects wild animals - rats, hares, monkeys, as well as domestic animals - cats, dogs, cows. Due to the very close contact of these animals with humans, humans also become infected. Infection also occurs through dirty hands. Toxoplasmosis (symptoms in children are described in detail below) is often transmitted to children through animal meat and chicken eggs.

Causes of the disease

Main sources of infection

Toxoplasma oocysts are found in soil, children's sandboxes, cat litter, as well as in meat and eggs that have not undergone sufficient heat treatment.

Very often, children become infected from domestic cats and dogs, after eating poorly cooked meat, and from infected animals.

Congenital toxoplasmosis

Toxoplasmosis is divided into two types: congenital and acquired. The congenital variant of the disease is transmitted to the child in the mother's womb. This situation is very dangerous for the baby’s health. Thus, transmission of the disease in early pregnancy almost always leads to spontaneous abortion. When infection occurs in the second trimester of pregnancy, the fetus often suffers irreversible damage to the central nervous system. In such cases, doctors refer the pregnant woman for premature birth. Pregnancy can end relatively favorably in cases where toxoplasmosis was detected in children in the third trimester. In this case, symptoms of the disease can only be identified at the birth of the baby. Manifestations in the mother are possible, but it is not always possible to differentiate them from the common cold, since in adults this disease is quite mild and unnoticeable. Detection of toxoplasmosis in pregnant women usually occurs by chance, during routine tests. Symptoms of toxoplasmosis in children can only be noticed after birth. Children infected in utero in the third trimester of pregnancy have a fairly good chance of recovery without critical complications.

Acquired toxoplasmosis

This type of disease is much less dangerous for a child and in most cases can be successfully treated or regresses on its own. Without treatment, the disease can also become chronic. Young children suffering from toxoplasmosis can suffer from this disease in acute and chronic forms. The second is diagnosed less frequently, as it often occurs without clinically significant symptoms. The acute form of the disease is difficult, but can be successfully treated.

Diagnosis of toxoplasmosis

Doctors are trying to cover in detail the problem of children becoming infected with a disease such as toxoplasmosis. Symptoms, analysis, and treatment in children are covered in detail in popular science articles and magazines for mothers. However, due to the fact that the disease most often occurs without pronounced clinical signs, mothers do not notice its onset and mistakenly mistake the symptoms of toxoplasmosis in the acute period for ARVI.

To diagnose the disease, a serological blood test is performed to determine antibodies to the causative agent of the disease. An auxiliary role in making a diagnosis can be played by examination, evaluation of ECG and EEG, and examination of the affected muscles.

Symptoms of toxoplasmosis

The incubation period after Toxoplasma enters the body lasts from 2 days to 3 weeks, but can be extended to several months. The duration of this period depends on the activity of Toxoplasma, the state of the child’s immunity and the severity of infection.

Toxoplasmosis in children symptoms (treatment, causes are described in detail in this article) in the acute period have the following:

• a sharp increase in temperature to +38C;
• an increase in the size of the liver and spleen;
• weakness, headache and drowsiness of the child;
• chills, muscle pain, joint pain;
• loss of appetite;
• generalized on the surface of the skin;
• increase throughout the body;
• eye disorder - may be expressed by clouding of the lens or strabismus.

Toxoplasmosis in children, the symptoms, and types of this disease are very similar to the manifestations of many diseases known to mothers - ARVI, influenza. Therefore, if you have any alarming symptoms, you should consult a doctor.

Symptoms of toxoplasmosis in children, which occurs in a chronic form, may not manifest themselves at all, but parents should be alert to the situation when a child periodically experiences mild symptoms listed above.

Prevention of disease

Toxoplasmosis symptoms in children are mild; a child can live with the disease for the rest of his life without any health consequences. However, not every body is able to adequately resist the pathogen, so parents should take care to prevent the disease and protect the child from infection.

Preventive measures should include the following:

1. Pets should be periodically tested for toxoplasmosis.
2. If there are sick animals in the house, the child’s interaction with them should be limited to the maximum extent possible. In particular, the child should not have access to the cat litter box, and cats should sleep exclusively in strictly designated areas.
3. Meat and egg products must be thoroughly cooked.
4. Children's play areas should be kept clean.
5. The child must observe the rules of personal hygiene - wash hands before eating and after walking, eat thoroughly peeled fruits and vegetables.
6. Pregnant women must be tested for antibodies to Toxoplasma, and newborns must be tested at birth. Seronegative diagnostic methods should be repeated in each trimester of pregnancy.
7. During pregnancy, a woman should limit contact with animals and be careful when choosing foods.

Treatment of toxoplasmosis

Treatment of the disease is prescribed by an infectious disease specialist or therapist and is carried out under their supervision. During treatment, indicators of the body's hematopoietic function and kidney function are strictly monitored.

The set of remedies against toxoplasma usually includes hormonal therapy (glucocorticoids), relief of allergic manifestations with the help of stimulants of the hematopoietic function of the body, sedatives and vitamin complexes.

Children who have had acute toxoplasmosis, as well as those who have the disease in a chronic form, are regularly examined by a neurologist, ophthalmologist and infectious disease specialist for reinfection and complications.

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General information

Diagnosis of congenital toxoplasmosis

Diagnosis of congenital toxoplasmosis can be carried out in the antenatal and postnatal period. Antenatal examination involves the use of invasive methods with further laboratory tests. The absolute indication for their implementation is acute maternal toxoplasmosis combined with fetal developmental disorders according to the results of obstetric ultrasound. The choice of research technique depends on the stage of pregnancy. For gestation from 10 weeks, a chorionic villus biopsy is performed, from 16 weeks - amniocentesis, from 18 - cordocentesis. To verify the infection, the resulting material is examined using PCR. Postnatal diagnosis includes collecting anamnestic data and conducting clinical and laboratory tests. This measure is mandatory for all children at risk of intrauterine infection. Nonspecific diagnosis and its results depend on the symptoms and syndromes present. The list of studies may include CBC (anemia, thrombocytopenia, leukocytosis); radiography of the chest cavity (signs of pulmonary infiltration); neurosonography and CT scan of the brain; biochemical blood test with measurement of ALT and AST, determination of CRP, bilirubin level and its fractions (all indicators are above normal); ophthalmoscopy (retinal necrosis); spinal puncture (signs of inflammation). Specific methods involve serodiagnosis of biological fluids using the ELISA method, in which an increase in the titer of IgG antibodies by 4 or more times and a high level of IgM are observed for 10-14 days. If necessary, PCR is performed to identify Toxoplasma DNA.

Treatment of congenital toxoplasmosis

Treatment of a newborn with a pronounced clinical picture of congenital toxoplasmosis is carried out only in a hospital setting, in the neonatal pathology department. Compliance with a specific regimen and diet is not required; their correction is carried out in accordance with the child’s condition. If the mother has a complicated medical history, etiotropic therapy begins from the moment the preliminary diagnosis is made. In other cases, laboratory tests are required before starting treatment. Regimen used: pyrimethamine and sulfadimezine for 1-1.5 months; spiramycin or other macrolides for 4-6 weeks. In some cases, systemic glucocorticosteroids - prednisolone - are used. Symptomatic treatment depends on the presenting symptoms and syndromes identified by the pediatrician or neonatologist. With a persistent increase in intracranial pressure or the development of hydrocephalus, surgical treatment is indicated. If necessary, further treatment can be carried out on an outpatient basis under the supervision of a pediatrician, infectious disease specialist and other specialists. Under the same conditions, therapy is carried out for subclinical and latent forms of congenital toxoplasmosis. The decision to refuse to take medications is made on the basis of clinical and laboratory parameters that are within the age norm, and the conclusion of all attending physicians.

Forecast and prevention of congenital toxoplasmosis

The prognosis for congenital toxoplasmosis depends on the trimester in which the fetus was infected and the severity of clinical manifestations. With the development of pathology in the first trimester, spontaneous termination of pregnancy and miscarriage or further development of severe forms of the disease may occur, but organ abnormalities do not occur. With adequate and timely therapy, the prognosis for life is favorable, but for recovery it is doubtful. Nonspecific prevention of congenital toxoplasmosis includes limiting contact of pets with a pregnant woman, maintaining hygiene standards, eating only thermally processed foods, and thoroughly washing vegetables and fruits. If there are factors indicating possible infection of the mother, specific diagnostics are carried out aimed at identifying T. gondii. Once the diagnosis is confirmed, immediate etiotropic therapy is indicated. Specific prevention of congenital toxoplasmosis has not been developed.

A child's body is more susceptible to damage by various types of pathogens than an adult. After entering the mucous membranes, they actively multiply, which provokes infectious or non-infectious pathologies, among which are toxoplasmosis in children.

The child’s symptoms will depend, first of all, on the stage of the pathology and the protective functions of the body. The disease can change from an acute form to a chronic one.

According to statistics, 60 percent of the population shows traces of infection with the virus.

Provoking factors and routes of transmission

Toxoplasma enters the external environment through feces and thus becomes the cause of infection of other animals and humans.

Thus, the routes of transmission of the infectious agent can be divided into three groups:

• contact;
• nutritional;
• transplacental.

An infected child will not pose a danger to others.

Transmission of the pathogen between people is possible only as a result of blood transfusion. Other methods have not been identified.

Classification of toxoplasmosis in a child

According to the type of origin, pathology is divided into:

• congenital – infection of a child with toxoplasmosis occurs during intrauterine development;
• acquired – infection is possible throughout life.

Regardless of how the virus entered the body, the disease has three forms in its course:

• acute - its peculiarity lies in the severity of the clinical picture and acute manifestation;
• chronic – development occurs gradually, symptoms are less pronounced;
• latent – ​​complete absence of symptoms. In this form, toxoplasmosis can remain in the body for up to several years, but at some point it will definitely make itself felt.

In cases where the newborn already has an acute development of the disease, the chances of life are very small, since the disease leads to complications such as paralysis of the eyes, limbs, liver enlargement and disturbances in motor and mental activity. In any case, the child will be disabled for the rest of his life.

The immune system is able to cope with an infectious pathogen if a small amount of it enters the body.

Symptoms of pathology

Based on the course and form of the disease, how toxoplasmosis manifests itself will directly depend.

The first characteristic signs of the disease make themselves felt in the period from the third to the twenty-first day from the moment of infection.

As a rule, a chronic disease occurs without any symptoms. However, in some cases it may be accompanied by the following symptoms:

1. If the eyes are affected, then conjunctivitis, keratitis, ascertain, and optic neuritis cannot be ruled out.
2. As a result of damage to the heart, the nutrition of its muscles is disrupted.
3. With pathology of the nervous system, epilepsy, increased intracerebral pressure, and disorders of the vegetative-vascular, endocrine and metabolic systems are possible.

In the acute form of toxoplasmosis, the following symptoms are observed in children:

• headache;
• poor appetite;
• temperature within 38-39 degrees;
• general weakness and malaise;
• weight loss;
• skin rash;
• lymphadenitis in the groin, armpits and neck.

In newborns and infants, in addition to the above, the following are added:

• jaundice;
• convulsions;
• hydrocephalus;
• enlargement of the spleen and liver.

If severe symptoms occur, you should immediately seek medical help.

Diagnostics

Diagnosis of the disease is carried out by an infectious disease specialist. If toxoplasmosis is suspected in children, the following necessary examinations are carried out:

1. Inspection. At this stage, the specialist collects information about existing complaints, the presence of an animal in the house, assesses the general condition, determines whether there is an enlargement of the liver, lymph nodes and spleen.
2. Blood analysis:
   • general - in the presence of pathology, indicators will indicate a developing inflammatory process;
   • enzyme immunoassay – detects the presence of antibodies to Toxoplasma;
   • biochemical – allows you to determine existing disorders in the liver.
3. Polymer chain reaction. Determines the content of Toxoplasma DNA in the blood.
4. Level of reaction to toxoplasmin. With this method, a small amount of a weakened pathogen is injected under the skin. A pronounced reaction in the form of swelling and redness may indicate the presence of an infection in the child’s body.
5. Blood culture.

The congenital form of toxoplasmosis can be diagnosed by examining fetal amniotic fluid.

Treatment

In the absence of characteristic signs of the disease, there is no need for treatment, since the body itself is able to cope with the pathogenic pathogen, thereby developing stable immunity to the virus.

If there are concomitant symptoms of toxoplasmosis, treatment with medications is prescribed. The scheme in each individual case is developed individually depending on the development and course of the pathology.

In total, therapy can last for 12 months. The following groups of medications are prescribed:

Treatment measures for the congenital form of toxoplasmosis should be started at the time of intrauterine development of the fetus, regardless of whether signs of pathology are present or not. The sooner treatment is carried out, the more effective it will be in suppressing possible complications associated with damage to the child’s central nervous system.

From the point of view of possible complications, the greatest danger is represented by congenital toxoplasmosis. Often, if a woman experiences a similar disease during the first and second trimesters, she is advised to terminate the pregnancy. Infection during intrauterine development leads to quite serious consequences in the field of ophthalmology, which often ends in blindness. Deformity, mental retardation, or death are also possible.

Other complications include:

• anaphylactic shock;
• Quincke's edema;
• encephalitis;
• pneumonia;
• arachnoiditis;
• cerebral edema;
• epileptiform syndrome.

Only timely initiation of therapy will prevent the development of such serious and dangerous complications.

Disease Prevention

To prevent the development of toxoplasmosis in children, it is necessary to follow a number of simple recommendations and basic hygiene rules:

1. Be sure to wash your hands after touching an animal.
2. Regularly examine cats living in your home for the presence of toxoplasma.
3. Clean your cat's litter box in a timely manner, preferably wearing gloves.
4. For consumption, use only high-quality meat and eggs that have undergone heat treatment.
5. Protect your child from contact with street animals as much as possible.
6. Strengthen the baby's immune system.
7. You should always wash fruits and vegetables well.
8. Regularly have your child examined by a pediatrician.

As a rule, only the congenital form of toxoplasmosis poses a serious danger to the child and his life. The acquired disease can be successfully treated and does not negatively affect health in any way.

Nervousness, sleep and appetite disturbances, immune disorders, intestinal dysbiosis and stomach pain... All these symptoms are familiar to you firsthand.

Advice: In order to eliminate the risk of a child contracting toxoplasmosis, it is necessary to examine domestic cats for the presence of this disease and limit their contact with stray animals.

Types and forms of toxoplasmosis

As you can see, toxoplasmosis can be acquired and congenital. The main forms of the disease are as follows:

• Chronic. The symptoms are not pronounced, the disease develops gradually.
• Spicy. There is a pronounced clinical picture and exacerbation of symptoms in the early stages.

The first symptoms of toxoplasmosis appear within 3-21 days after infection.

Symptoms of acute toxoplasmosis in children

• Reducing the child's weight.
• Pain in joints and muscles.
• General malaise.
• Headache.
• Loss of appetite.
• Weakness.
• Temperature 38-39 degrees.
• A maculopapular rash on the body, excluding the scalp, feet and palms.
• Acute inflammation of the lymph nodes near the neck, groin and armpit.

In addition to these symptoms, infants and newborns may have the following health problems:

• Jaundice.
• Cramps.
• Enlarged liver and spleen.
• Increased head size.

Symptoms of chronic toxoplasmosis in children

In some cases, toxoplasmosis is asymptomatic, but not always. The following symptoms may be observed:

• When the eyes are damaged, conjunctivitis (inflammation of the mucous membrane of the eyes), uveitis (inflammation of the choroid), optic neuritis, and keratitis (inflammation of the cornea of ​​the eye) develop. Symptoms: eye redness, clouding, cornea, pain, itching, fatigue.
• If the nervous system is damaged, there may be epilepsy, vegetative-vascular disorders, increased intracerebral pressure, disruption of the endocrine system and metabolism.
• When the heart is damaged, a malnutrition of the heart muscle occurs, which causes disruptions in the functioning of not only this organ, but also others, and there may also be inflammation of the heart muscle and chest muscles.

Advice: It is necessary to increase the child’s immunity, since weakened children are primarily susceptible to toxoplasmosis. In this regard, hardening, playing sports, eating large amounts of fresh fruits and vegetables, and walking in the fresh air are suitable.

Treatment of toxoplasmosis in a child

In cases where there are no pronounced symptoms of toxoplasmosis in children, treatment is not carried out, since the body itself will cope with the infection without outside help and develop strong immunity. Re-infection with toxoplasmosis is possible, but this phenomenon is extremely rare.

If symptoms of toxoplasmosis appear in a child, drug treatment is prescribed. The treatment regimen is developed individually by the appropriate medical specialist. Treatment of toxoplasmosis can last for a year, using immunostimulating, etiotropic, pathogenetic, and symptomatic agents.

The most dangerous. Sometimes this can become a reason for premature termination of pregnancy if a woman is diagnosed with toxoplasmosis in the first and second trimester. Infection of the fetus leads to mental retardation, deformity, blindness, and in some cases, death of the embryo.

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