Determining how to treat toxoplasmosis , the form of the disease, the degree of damage to the body, problems with the immune system and many other factors should be taken into account. Is it possible to do without potent antibacterial drugs?
Specifics of the disease
The chronic form is not easy to cure, but early stages the prognosis is positive in most cases. For treatment, antibiotics are used in various combinations with drugs that enhance immune defense.
When should toxoplasmosis be treated?
Not all carriers of Toxoplasma require treatment. The disease often occurs in a latent, hidden form and does not pose a danger. People without serious pathologies immune system are able to heal on their own without the use of medications. Therapy is necessary only for people with immunodeficiency, children and pregnant women, as well as those in whom toxoplasmosis becomes acute.
The intensity of the disease is greatly influenced by the health status of the carrier of the infection, primarily regarding the immune system. The acute form often occurs under circumstances that undermine the body's defenses: 
- Reduced immunity;
- Severe stress;
- Exhaustion of the body;
- Chronic diseases;
- Pregnancy.
Acute toxoplasmosis requires immediate and competent treatment, which can only be prescribed by a doctor. In those suffering from immunodeficiency, the disease becomes very severe and even fatal. The first symptoms of the disease resemble encephalitis, typhus or pneumonia.
The infection often affects the eyes, the spleen, liver and lymph nodes become enlarged, the temperature rises and remains quite high for a long time (up to 7 days). Convulsions and vomiting begin, and the patient may experience paralysis. Treatment is prescribed after a laboratory test, the indications for which are the following symptoms:
- The elevated temperature persists for several days;
- Pain in the limbs (muscular or joint);
- Nausea, weakness and vomiting.
Toxoplasmosis is especially dangerous for pregnant women; it causes fetal development defects, miscarriages and intrauterine deformities. If the infection occurs in the last trimesters, the child acquires a congenital form of infection, which becomes acute if there are problems with the immune system. If primary toxoplasmosis is detected at an early stage, the woman is offered an abortion; the prognosis for the fetus in these circumstances is disappointing.
Treatment methods
Treatment of toxoplasmosis in humans differs for different forms of the disease. Complex therapy is aimed at relieving acute symptoms and destroying pathogenic microorganisms. If the disease has not yet developed into a protracted chronic form, the use of antibiotics almost always gives positive results.
The following are used to treat toxoplasmosis:
- Glucocorticoids;
- Antihistamines;
- Vitamin complexes;
- Facilities traditional medicine.
Drugs for the treatment of toxoplasmosis
Many drugs for the treatment of toxoplasmosis have antimalarial properties. The carriers of these diseases are very similar, and the routes of infection are also similar. Most strong antibacterial agents are not suitable for pregnant women, but there are exceptions.
Doxycycline is a tetracycline antibiotic; it inhibits protein synthesis in the microbial cell. The drug is contraindicated during pregnancy; in the second half of pregnancy it is strictly prohibited. It should not be taken by children under 8 years of age, women during lactation, with hepatic or renal failure. The course of treatment lasts 10-14 days.
This antibacterial agent has fewer contraindications than other similar antibiotics. The drug slightly inhibits intestinal microflora, compared to other tetracyclines, its duration of action is longer, and absorption into cells is more complete. Doxycycline can be successfully combined with Clindamycin, but when taken simultaneously with Cholestyramine or Colestipol, absorption is impaired.
Spiramycin is used to treat toxoplasmosis during pregnancy, but the drug should not be used while breastfeeding. The drug is not prescribed when the liver is affected; it can accumulate in this organ and negatively affect its functions.
Pyrimethamine destroys the spores of the pathogen and helps interrupt the cyclic transmission of the disease to another person.
For toxoplasmosis, it is prescribed together with sulfadimezine and folic acid.
Every week you should take a blood test and monitor the number of red blood cells, the drug has a strong effect on them.
The drug should not be taken during pregnancy. It is also prohibited for people with anemia, impaired erythropoiesis and severe deficiency folic acid. When treating with Pyrimethamine, it is recommended to drink plenty of fluids.
Clindamycin helps well in advanced stages of the disease, but the list of its contraindications is extensive. The main active ingredient of the drug is lincosamides. It is a broad-spectrum antibiotic that inhibits protein synthesis in pathological microorganisms.
The medicine should not be taken for bronchial asthma, ulcerative colitis and hereditary diseases such as lactose intolerance. Concomitant food intake slows down the absorption of the antibiotic. It is not prescribed to elderly people, children under 3 years of age and patients with renal failure.
Minocycline is a reserve drug for the treatment of toxoplasmosis. It is used if other antibacterial agents are powerless or for some reason are contraindicated. The active substance stops the growth and reproduction of bacteria, and it also has a moderate anti-inflammatory effect.
It is not recommended to combine Minocycline with milk, as the absorption of the drug slows down. Children can take it from the age of 8, the dose is calculated depending on the child’s weight. This should be done with caution, as the product negatively affects the processes of growth and skeletal formation.
Fansidar is used to treat toxoplasmosis and malaria. The active ingredients of the drug are pyramethamine and sulfadoxine. It is very effective in combination with immunostimulants, Galovit and Polyoxidonium. Concomitant use with chloroquine increases the side effects of these two drugs.
Children can take Fansidar from 2 months of age. This is one of the drugs used during pregnancy. It is used only for critical indications and requires constant medical supervision. It is necessary to check blood counts and liver tests if treatment is prolonged. Exposure to the sun should be avoided. In some cases, long-term therapy (up to 3 months) is possible.
When side effects such as rash, sore throat, fever, convulsions, cough, you should immediately stop taking the medicine.
Antibiotic should not be combined with ascorbic acid and B vitamins, potassium chloride, radiocontrast agents and many other substances. Elderly patients should be careful.
This medicine has analogues: Lorikacin, Ambiotik, Flexerit. Like Amikacin itself, they are not available in tablets; the active substance is poorly absorbed in the gastrointestinal tract. There are only solutions in injection ampoules and powders for their preparation.
During pregnancy and lactation, use is permissible if the benefit of treatment outweighs the risk to the child. The intake process should be monitored by a doctor, who will also select additional medications to strengthen the immune system. Patients with epilepsy and diseases of the gastrointestinal tract should take the medicine with great caution.
Traditional medicine methods
Traditional medicine can only be used as complementary therapy. They have a positive effect on the state of the immune system, which helps activate the body's protective reserves to fight toxoplasma.
Decoction of medicinal herbs
It’s easy to make medicinal herbal infusions yourself; all the ingredients are sold in pharmacies and are inexpensive. The decoction is taken on an empty stomach 2-3 times a day, one tablespoon. Treatment is continued until the symptoms of the disease disappear. To prepare the mixture, you need to take in equal proportions: 
- Buckthorn bark;
- Tansy;
- Chamomile;
- Gentian;
- Sagebrush.
One tablespoon of herbal mixture is poured into a glass of water and left in a thermos overnight. In the morning, filter the broth.
Vodka tincture
A mixture of medicinal herbs can also be used to prepare a tincture. The product is used only for the treatment of adults. You will need a glass vessel, pour into it: 
- Rhizomes of aila;
- Aspen bark;
- Eucalyptus leaves.
Mix everything well until smooth and pour in vodka. The container is placed in dark place for 3 days. The tincture is taken after meals, a tablespoon 3 times a day.
Toxoplasmosis needs to be treated with tablets
Routes of infection
A more rare method of infection is through damaged skin or mucous membranes of organs. In medical practice, there have been cases where a person was infected through a blood transfusion or organ transplantation.
Possible routes of infection with toxoplasmosis
It was said above that during pregnancy there is a risk that the child will become infected from the mother while still in the womb. The thing is that toxoplasma is able to overcome the placental barrier, so the chances of not infecting the fetus will be minimal.
Diagnosis of toxoplasmosis
In case of intrauterine infection, the history of pregnancy, data from studies on TORCH infections in a woman and serological reactions in an infant are taken into account. Test results are also taken into account amniotic fluid and placenta by PCR.
Newborns should be observed by an ophthalmologist, neurologist, and otolaryngologist. A puncture and CT scan of the brain, neurosonography are prescribed.
A serious examination will be required to detect an infection.
If toxoplasmosis is acquired, the patient is prescribed an EEG, Echo-EG, CT scan of the skull, and ECG. Consultation with a neurologist, cardiologist and other specialists will also be required.
For laboratory tests, fingerprint smears taken from the affected organs, blood, and cerebrospinal fluid are taken for analysis.
Immunological studies include serological methods, intradermal allergy test with toxoplasmin.
Treatment
To combat toxoplasmosis, methods are provided that are based on the use of medications.
Therapy depends on the clinical picture of the disease and on how the patient was infected. The disease can be congenital or acquired. The latter form is divided into acute and chronic.
All therapy is based on medication
For acute toxoplasmosis, the doctor prescribes antibiotics and chemotherapy. All medications used for treatment are highly effective.
If toxoplasmosis has become chronic, it will not be easy to treat. All that a doctor can do in this case is to transform the disease into a latent form. Often, therapy is resorted to at the time of exacerbation.
Immunocorrections and hyposensitizing drugs play a significant role in therapy. To overcome the disease, you need to focus all your efforts on strengthening your immune system.
Elimination of acute symptoms is another important goal of therapy. What the main course of treatment will be depends on the form of the disease and the patient’s condition.
Medicines for toxoplasmosis
As a rule, medications such as Amikacin, Rovamycin, and Fansidar are prescribed for the treatment of toxoplasmosis.
This drug is prohibited in the first trimester of pregnancy and lactation. A contraindication to it is also individual intolerance to the components.
"Amikacin" is a drug from a series of aminoglycosides. Promotes the destruction of the cytoplasmic membranes of pathogenic organisms. It is prescribed in most cases for the purpose of preventing helminths for women at the time of planning pregnancy.
Rovamycin is one of the most effective drugs in the fight against toxoplasmosis
"Rovamycin" is a macrolide medicine, which is one of the most effective drugs in the fight against toxoplasmosis. Available in the form of tablets and liquid for injection. The main substance is spiramycin. The drug is not contraindicated during pregnancy, but it is not prescribed to lactating women. The drug is also not prescribed to children under 6 years of age.
By what signs can toxoplasmosis be recognized?
Timely treatment of toxoplasmosis is the key to successful recovery. To prevent the disease from developing into a chronic form and causing a serious blow to a person’s health, it is important to identify its signs. Symptoms of acquired toxoplasmosis differ from those characteristic of the congenital form.
Manifestations of acquired toxoplasmosis include:
- allergic skin rash;
- an increase in temperature that cannot be brought down with antipyretic drugs;
- general malaise;
- enlarged liver or spleen;
- migraine;
- muscle pain;
- lymphadenitis;
- loss of appetite;
- memory problems;
- increased irritability.
One of the symptoms is high fever
In the acute course of toxoplasmosis, a sharp increase in temperature and signs of intoxication are observed. In addition, vision may deteriorate.
The sooner treatment is started, the higher the likelihood that the disease will not lead to serious consequences.
Symptoms of chronic toxoplasmosis are most often observed in people with immunodeficiency (HIV infection carriers). In patients with AIDS, the disease can lead to purulent processes in the brain, meningoencephalitis, heart disease, and lung damage. In many cases, signs of invasion can be in the form of autonomic dysfunction. If a person has AIDS, there is a risk of death.
Toxoplasmosis in women in the first trimester of pregnancy in most cases leads to miscarriage. If a woman is infected towards the end of pregnancy, the baby may be delayed in development and will have congenital diseases of the liver and spleen. Previously, children infected with toxoplasma, in rare cases, lived up to 5 years. Modern medicine has advanced so much that this disease can be transferred into a period of remission, and in best case scenario and get rid of it completely.
Treatment of toxoplasmosis in pregnant women and children
Therapy for, exactly as in adults, involves complex measures. If a child’s illness is acute, it is important to provide him with bed rest in order to protect him from serious consequences. For congenital diseases, the following drugs are often used: Pyrimethamine, Sulfadiazine, calcium folinate. The treatment plan for the newborn is drawn up by the doctor.
When treating worms, complex therapy is carried out
If toxoplasmosis is acquired, medications are prescribed in the form of Rovamycin, Fansidar, Biseptol. Self-medication is highly discouraged.
Prognosis for toxoplasmosis
If toxoplasmosis is acquired, the prognosis for treatment will be favorable. In persons with AIDS and patients with immunodeficiency, the disease occurs with complications. In this case, there is a high probability of death.
Clinical examination
Patients with acute acquired toxoplasmosis and those whose disease is chronic require inpatient treatment. HIV-infected patients are also subject to medical examination.
Chronic toxoplasmosis requires hospital treatment
The duration of therapy in a hospital setting depends on the clinical picture of the disease and its manifestations. In case of congenital pathology in children, the issue of medical examination is decided at a council where neuropathologists, ophthalmologists and other doctors are present.
In severe forms of toxoplasmosis, when it occurs, lifelong hospitalization may be required. This also applies to HIV patients.
Why is it dangerous?
Not everyone can boast of strong immunity.
If toxoplasmosis occurs in a latent form and cannot be diagnosed in the early stages of development, this can lead to disruption of the brain, nervous system, heart damage.
The most common serious consequences of toxoplasmosis include:
- schizophrenia;
- arthritis;
- inflammation of the brain, development of tumors in it;
- blindness;
- severe depression.
Toxoplasma affects the central nervous system, which causes the patient to become distracted. The threat to the baby arises when the mother is initially infected while she is pregnant. The protozoa penetrate the blood and cross the placental barrier, which can cause the following pathologies in a newborn:
- congenital lesions of the eyes, brain, liver;
- congenital anomalies.
Prevention measures
It is important to monitor your health during pregnancy
- After visiting crowded places, contacting animals, or using the toilet, you must wash your hands using soap with a disinfecting effect.
- Meat and fish must be fully cooked. Cutting boards They must be washed thoroughly and not used for other products. You need to purchase meat and fish only from trusted places.
- If there is a cat living in the house, it must be wormed regularly. When the first signs appear, you should immediately take him to the veterinary clinic.
- When cleaning the cat litter, you should only wear gloves and wash your hands afterwards. It is advisable to use special fillers for trays. It is highly not recommended for pregnant women to carry out such manipulations.
- If a woman is planning a pregnancy, she should take
Therefore, if the body of a healthy person with good immunity Toxoplasma enters, in response to them, the formation of antibodies will begin, which will soon overcome the disease, subsequently developing lasting immunity. However, if a person has a decrease in immunity, antibodies may be produced in insufficient quantities or absent altogether. In this case, there will be a predominance of toxoplasma, which will subsequently infect the body and cause a disease such as toxoplasmosis.
There are the following ranks of microorganisms:
- superkingdom ( domain);
- kingdom;
- supertype;
- Class;
- order;
- family;
- subspecies.
Eukaryotes are higher organisms that have a common structure characteristic only of a given domain. The main feature of a eukaryotic cell is the presence in it of a clearly defined nucleus, which contains a DNA macromolecule responsible for the storage, transmission and implementation of genetic information.
The following kingdoms belong to eukaryotes:
- animals;
- plants;
- mushrooms
There are seven types of protozoan microorganisms, which mainly differ from each other in their characteristic mode of movement.
Of the seven types of microorganisms, only three types can cause a specific disease in humans:
- sarcomastigophores ( Sarcomastigophora);
- ciliates ( Ciliophora);
- Sporozoans ( Apicomplexa).
Note. Romanovsky-Giemsa staining is a cytological research method that allows you to differentiate the type of microorganism, as well as study the chemical processes occurring in the cell.
Ripening ( sporulation) cysts, after which they are considered infectious, occurs over a certain period of time, all depending on the temperature of the external environment.
At a temperature of plus four degrees In Celsius, sporulation occurs in two to three days.
At a temperature of plus eleven Ripening occurs within five to eight days.
At a temperature of plus fifteen The oocysts will take about three weeks to sporulate.
Note. Maturation of oocysts is impossible at temperatures below plus four and above plus thirty-seven degrees Celsius.
Depending on the duration of pregnancy, congenital toxoplasmosis can be divided into two groups:
- early congenital toxoplasmosis, in which the mother, and consequently the fetus, is infected in the first months of pregnancy;
- late congenital toxoplasmosis, in which a pregnant woman becomes infected with toxoplasmosis and transmits the disease to the fetus in the second half of pregnancy.
With late congenital toxoplasmosis, a child may be born with signs of generalized toxoplasmosis ( for example, enlarged liver, spleen).
The following forms of congenital toxoplasmosis exist:
- acute form;
- chronic form.
| Symptoms acute form congenital toxoplasmosis | Symptoms of the chronic form of congenital toxoplasmosis |
|
|
Symptoms of acquired toxoplasmosis
The following periods of the disease are distinguished:- incubation period;
- prodromal period;
- peak period;
- period of convalescence.
| Period of illness | Duration of the period | Description of the period |
| Incubation period | from three days to two weeks | Characterized by the proliferation of pathogens and the accumulation of toxins. This period lasts from the moment the microorganism enters the body until the first symptoms appear. |
| Prodromal period | within one to two weeks | Characterized by the appearance of the first nonspecific clinical symptoms (for example, fever, malaise, swollen lymph nodes). This period can begin acutely or gradually. |
| High period | two to three weeks | There is a subsidence of nonspecific symptoms of the disease. The vital activity of the body’s immune cells is also inhibited, which subsequently leads to the development of pathological conditions of the cardiovascular, musculoskeletal and nervous systems. |
| Convalescence period | in the third – fourth week of the disease, a gradual disappearance of all clinical symptoms is observed | It is characterized by the disappearance of signs of the disease and the onset of stable immunity, which is developed for life. |
Note. In a healthy person, this disease, as a rule, proceeds almost unnoticed, without pronounced symptoms. The patient may experience symptoms such as a slight increase in body temperature, weakness, headache, swollen lymph nodes that usually go away within one week. However, if a person experiences a decrease in the body’s defenses ( for example, with HIV infection), then toxoplasmosis occurs more severely with damage various systems, organs and tissues ( e.g. nervous system, heart, eyes, skeletal muscles).
There are three forms of acquired toxoplasmosis:
- acute form;
- chronic form;
- latent form.
Acute form
This form in most cases is characterized by an acute onset of the disease.In the acute form, the patient may experience the following signs of the disease:
- increase in body temperature to 38 - 39 degrees;
- signs of intoxication of the body, for example, loss of appetite, pain in muscles and joints, weakness ( develop as a result of internal effects on the body of toxins released by the causative agent of the disease);
- enlarged lymph nodes, in most cases cervical and occipital ( increase in size and become dense);
- hepatosplenomegaly ( enlarged liver and spleen).
Chronic form
Characterized by various manifestations over a long period of time. With this form of the disease there is a long ( within a few months) an increase in body temperature within 37 - 37.9 degrees, as well as manifestations of intoxication of the body, which can subsequently lead to damage to various organs and systems ( for example, damage to the eyes, heart, muscular system).During this period, the patient may be bothered by symptoms such as increased weakness, nervousness, headaches, memory impairment, as well as painful sensations in muscles and joints. It should also be noted that the chronic form is characterized by enlargement of the lymph nodes - usually cervical, supraclavicular, axillary and inguinal.
The chronic form of toxoplasmosis can lead to damage to the following body systems:
- gastrointestinal tract;
- the cardiovascular system;
- nervous system;
- endocrine system;
- visual system.
- decreased appetite;
- bowel dysfunction;
- weight loss;
- abdominal pain;
- liver enlargement and pain;
- disruption of the pancreas.
- increased heart rate ( tachycardia);
- decrease in blood pressure ( below 120 to 80 millimeters of mercury);
Damage to the nervous system due to toxoplasmosis can lead to the development of the following symptoms:
- emotional instability;
- irritability;
- decreased performance;
- menstrual irregularities;
- hypofunction of the thyroid gland.
- chorioretinitis ( inflammation of the choroid and retina);
- uveitis ( inflammation of the choroid);
- conjunctivitis ( inflammation of the conjunctiva);
- iritis ( inflammation of the iris).
- painful sensations in the eyes;
- hyperemia ( redness) eye;
- lacrimation;
- increased sensitivity to light stimuli;
Latent form
This form of toxoplasmosis is characterized by an asymptomatic course, and, as a rule, the disease is detected only after research.Diagnosis of toxoplasmosis
Diagnosis of toxoplasmosis includes:
- taking anamnesis;
- examination of the patient;
- laboratory research;
- instrumental diagnostics.
History taking
Anamnesis collection includes:- medical history ( chronological description of the onset of symptoms of the disease);
- anamnesis of life ( description of living conditions, food habits, profession);
- epidemiological history ( it is determined whether there was contact with animals, the nature of the contact);
- allergy history ( Are you allergic and to what exactly?).
Examination of the patient
Examination of a patient with toxoplasmosis in the acute periodWhen examining a patient during this period, the doctor reveals:
- elevated body temperature ( usually low-grade fever);
- enlarged liver and spleen ( the liver is painful on palpation);
- enlarged lymph nodes ( soft in density, painful on palpation, size varies within one to one and a half centimeters, not connected to nearby tissues).
Examination of a patient with toxoplasmosis in the chronic period
| System | Examination of the patient | Patient's complaints |
| The cardiovascular system |
| The patient may complain of pain in the heart area, as well as weakness. |
| Gastrointestinal tract | When palpating the abdomen, dull pain in the epigastric area, bloating, and an increase in the size of the liver are observed ( painful on palpation). | The patient may complain of decreased appetite, dry mouth, nausea, constipation, and weight loss. |
| Musculoskeletal system | When palpating the muscles, the doctor can detect compactions, as well as muscle hypertonicity, which is accompanied by painful sensations. Also during the examination, limited joint mobility is observed. | Painful sensations in the muscles ( usually in the upper and lower limbs, lower back) and large or medium-sized joints ( for example, knees, elbows, ankles). The patient may also complain of muscle weakness. |
When examining the nervous system, the following is revealed:
- weakness;
- apathy;
- decreased performance.
Due to the fact that this period is characterized by an asymptomatic course, the examination of the patient is based on laboratory diagnostics and subsequent analysis of the research results.
Laboratory research
Serological methodIs effective method diagnosis of infectious and inflammatory diseases. This study is carried out by collecting venous blood and then centrifuging it to obtain serum, that is, the liquid part of the blood.
Then the resulting material is examined for the presence of specific antibodies in the blood serum:
- Ig detection ( immunoglobulin) M means the presence of an acute process;
- detection of Ig G indicates a transferred process.
The following serological tests are used in the diagnosis of toxoplasmosis:
- complement fixation reaction;
- Sebin-Feldman reaction;
- immunofluorescence reaction ( REEF);
- linked immunosorbent assay ( ELISA).
| Reaction name | Description of the reaction |
| Complement fixation reaction | When antigen and antibody bind, a special protein, complement, is subsequently attached, which leads to the formation of an immune complex. If the antibody and antigen do not bind to each other, then complement is therefore unable to attach to them, resulting in the absence of a complex. The complement fixation reaction is carried out by detecting the presence of a formed complex or its absence. With toxoplasmosis, this reaction will be positive starting from the second week of the disease. |
| Sebin-Feldman reaction | The essence of this method is that normally the contents of a living cell are colored blue using methylene blue. However, if there are antibodies in the serum, no staining occurs. This reaction is possible only in the presence of living Toxoplasma gondii. |
| Immunofluorescence reaction(REEF) | The material taken for research is applied to a glass slide in the form of a smear, which is subsequently treated with a special dye - fluorochrome. The dye serum, coming into contact with bacterial proteins during microscopic examination, causes their peripheral glow in the form of a green color ( direct reaction). Also, this research method can be carried out using an indirect reaction, which consists in the fact that the antiglobulin serum used is stained with fluorochrome and applied to a smear. This serum detects the presence of an antibody-antigen complex. Positive immunofluorescence reactions are observed starting from the first week after infection with toxoplasmosis. |
| Linked immunosorbent assay(ELISA) | Thanks to this analysis It is possible to detect the presence of Ig M, Ig G, Ig A antibodies or antigens of certain infections in the blood. ELISA helps to establish not only the existence of antibodies in the material being tested, but also to determine their quantity. |
Note. The final diagnosis of toxoplasmosis is established only after re-examination of the serum.
Allergological method
This research method involves performing an allergy test on the patient by injecting toxoplasmin intradermally. The drug is injected into the outer area of the shoulder in an amount of 0.1 ml.
Note. Toxoplasmin is a special antigenic complex of the pathogen, which is obtained by taking fluid from abdominal cavity in white mice suffering from toxoplasmosis.
At the site of toxoplasmin injection, redness may be observed on the surface of the skin ( hyperemia) and infiltrate ( accumulation of the injected substance in tissues).
When conducting an allergy test, the following reactions may be observed:
- strongly positive reaction (if the size of the intradermal reaction is more than twenty millimeters);
- positive reaction (if the size of the intradermal reaction is from thirteen to twenty millimeters);
- weakly positive reaction (if the size of the intradermal reaction is from ten to thirteen millimeters);
- negative reaction (if the size of the intradermal reaction is less than nine millimeters).
However, if M or A antibodies were detected in a woman during the study, and toxoplasmosis occurs with a pronounced clinical picture and damage to organs and systems is observed, then in this case complex treatment of the disease is prescribed ( e.g. chemotherapy, antibiotics, desensitization therapy). Adequately selected therapy helps to significantly reduce the severity of toxoplasmosis, as well as prevent damage to internal organs.
Note.
Treatment of toxoplasmosis ( medications and duration of treatment) is selected individually by the attending physician.
Treatment of toxoplasmosis is determined depending on the following indicators:
- the existing form of the disease;
- severity of the disease;
- the degree of damage to organs and systems of the body.
Treatment of acute toxoplasmosis
For toxoplasmosis, chemotherapeutic drugs that have a depressing effect on toxoplasma in the trophozoite stage are effectively used. The main representatives used in treatment of this disease, are antimalarial drugs that have an antimalarial effect and also have a detrimental effect on the causative agent of toxoplasmosis “Toxoplasma gondii”.| Name of the drug | Active substance | |
| Chloridine
(Daraprim) | Pyrimethamine |
in the first days of treatment, the drug is prescribed orally at a dose of 50 mg per day, in subsequent days it is reduced to 25 mg per day. Children from two to six years old:
Children under two years old:
The duration of treatment usually includes three cycles. Medicine is taken for five days, after which a seven- or ten-day break is taken, and the drug is repeated again. To enhance the therapeutic effect, pyrimethamine can be prescribed in combination with sulfadiazine. Adults and children over six years of age:
Children from two to six years old:
Children under two years old:
The above doses of sulfadiazine are administered in four doses. |
| Fansidar | Pyrimethamine, sulfadoxine | For adults:
It is recommended to take two tablets once every seven days for six weeks. If damage to the central nervous system is observed with toxoplasmosis, the drug is prescribed in combination with spiramycin ( macrolide antibiotic) in the amount of three grams per day, for three to four weeks. |
| Aminoquinol | Aminoquinol | For adults:
the drug is prescribed orally in an amount of 100–150 mg three times a day for seven days. The duration of treatment includes three cycles of seven days with ten- to fourteen-day breaks between each other. To increase effectiveness, the drug can be prescribed in combination with sulfadimezine at a dose of two grams, two to three times a day ( for adults). |
Note. This treatment negatively affects the bone marrow, which consumes a large amount of folic acid to renew tissue. Therefore, from the beginning of treatment, for the purpose of compensation, it is recommended to prescribe and simultaneously take folic acid in an amount of six to ten milligrams per day. It should also be noted that the course of therapy should be carried out under regular monitoring of peripheral blood.
In case of acute toxoplasmosis, antibiotics such as sulfonamides, tetracyclines and macrolides can be prescribed in combination with antimalarial drugs or individually ( have a depressing effect on various microorganisms, including toxoplasma).
| Name of the drug | Active substance | Method of use of the drug and its dosage |
| Biseptol | sulfamethoxazole, trimethoprim () | For adults:
the drug is prescribed orally at 960 mg twice a day.
Children from three to five years old:
The duration of treatment is prescribed individually, but, as a rule, therapy is carried out in two to three cycles of ten days. Note. In parallel, folic acid may be prescribed ( six to ten milligrams per day). |
| Sulfapyridazine | Sulfamethoxypyridazine (pharmacological group – sulfonamides) | For adults
on the first day, oral administration of one gram of the drug is indicated, after which the dose is reduced to 500 mg once a day. For children:
The duration of treatment is five to seven days. |
| Lincomycin hydrochloride | Lincomycin (pharmacological group – lincosamides) | For adults:
should be taken orally 500 mg two to three times a day. Children from three to fourteen years old:
The duration of treatment is determined individually depending on the available indications. |
| Metacycline hydrochloride | Metacycline (pharmacological group – tetracyclines) | For adults:
take 300 mg orally twice a day. Children from eight to twelve years old:
The duration of treatment is usually seven to ten days. |
| Metronidazole | Metronidazole (pharmacological group – synthetic antibacterial drug) | For adults:
take 250 mg orally twice a day for seven to ten days ( depending on indications). Children from five to ten years old: 375 mg is indicated, divided into two doses, over seven to ten days. Children from two to four years old:
Children under one year of age:
|
| Rovamycin | Spiramycin (pharmacological group – macrolides) | For adults:
the drug is prescribed orally in amounts of six to nine million international units ( two to three tablets) two to three times a day. For children(over twenty kilograms):
The duration of treatment is determined individually by the attending physician. |
Treatment of acute toxoplasmosis in pregnant women
Treatment during pregnancy aims not only to cure the disease in the mother, but also to prevent the development of congenital toxoplasmosis in the child.In the treatment of acute toxoplasmosis in pregnant women, in most cases, the drug Rovamycin is used, which after the sixteenth week is prescribed to the woman in the following dosage:
- one tablet orally ( 1.5 million action units) twice a day for six weeks;
- one tablet orally ( 3 million action units) twice a day for four weeks;
- one tablet orally ( 3 million action units) three times a day for ten days.
To prevent congenital toxoplasmosis, a pregnant woman may be prescribed the following medications:
- chloridine;
- aminoquinol.
The drug is prescribed from the sixteenth week of pregnancy. Treatment includes two cycles spaced ten days apart or three cycles spaced a month apart.
Aminoquinol
The drug is prescribed starting from the ninth week of pregnancy.
Treatment consists of four cycles:
- first cycle– ninth – fourteenth week of pregnancy;
- second cycle– fifteenth – twentieth week of pregnancy;
- third cycle– twenty-first – twenty-sixth week of pregnancy;
- fourth cycle– twenty-seventh – thirty-second week of pregnancy.
Treatment of chronic toxoplasmosis
As indicated, the above drugs act on the causative agent of toxoplasmosis when they are in the trophozoite stage. However, in the chronic form of the disease, toxoplasma in the human body is in the form of cysts, therefore antimalarial and antibacterial drugs do not have the desired therapeutic effect ( drugs are not able to penetrate into cysts) and, as a rule, are not used in the treatment of this stage of the disease.Treatment of chronic toxoplasmosis includes:
- taking immunostimulating drugs;
- carrying out desensitizing ( antiallergic) therapy;
- administration of toxoplasmin;
- carrying out ultraviolet irradiation.
These drugs are used in complex therapy for the treatment of toxoplasmosis, acting favorably on the body's defenses, they stimulate cellular and humoral immunity.
This therapy is necessary because the existing chronic infection provides negative impact on human immunity, significantly reducing it.
| Name of the drug | Method of use of the drug and its dosage |
| Lycopid | The drug is taken orally in a dose of one to two milligrams per day for ten days. |
| Taktivin | For adults:
the drug is administered subcutaneously in an amount of one milliliter once, every evening for five to fourteen days. Children from six months to fourteen years:
|
| Cycloferon | For adults:
three to four tablets are prescribed ( 150 mg each) once a day. Children from seven to eleven years old:
Children aged four to six years:
|
| Thymogen | The drug is administered intramuscularly in the following dosage:
|
Desensitization therapy
The mechanism of action of this group of drugs is that they block H-1 histamine receptors, which leads to a reduction or elimination of the allergic reaction.
| Name of the drug | Method of use of the drug and its dosage |
| Suprastin | For adults:
It is recommended to take one tablet ( 25 mg) three to four times a day. Children from six to fourteen years old:
Children from one to six years old:
Children from one month to one year:
|
| Diazolin | For adults:
take 100–300 mg orally ( one tablet contains 100 mg) per day. Children from five to ten years old:
Children from two to five years old:
Children under two years old:
|
| Tavegil | For adults:
one tablet orally ( one milligram) two to three times a day; as an injection intramuscularly or intravenously in an amount of two milligrams twice a day ( in the morning and in the evening). Children from six to twelve years old:
Children from one to six years old:
|
Note. Desensitizing and immunostimulating therapies are also used in the treatment of acute toxoplasmosis.
Specific immunotherapy with toxoplasmin
Before starting immunotherapy with toxoplasmin, an allergy test of 0.1 ml intradermally in three weak concentrations is first done, followed by reading the result a day later. If there is no local or general reaction to the drug, a more concentrated dose of toxoplasmin is administered after 24 hours. Then, a day later, an even more concentrated dose of 0.1 ml is administered intradermally at four different points, which subsequently causes a general and local reaction. The reaction is assessed every day. As soon as the reaction subsides, the drug is reintroduced, while the concentration of toxoplasmin is increased, and the points at which the drug is administered are eventually increased to ten.Note. Toxoplasmin is administered if the patient does not have diseases associated with eye damage.
Ultraviolet irradiation
Treatment, as a rule, begins with the administration of a quarter of the biological dose, observing the skin reaction, the dose is increased by a quarter daily or every other day.Prevention of toxoplasmosis
Prevention of toxoplasmosis is as follows:- maintaining personal hygiene rules;
- decreased contact with cats;
- exclusion of eating raw, as well as poorly fried or boiled meat or minced meat;
- when consuming vegetables, fruits or berries that come into contact with the ground, they should be washed thoroughly;
- if you have a cat at home, it is recommended to regularly examine the animal for toxoplasmosis;
- when planning pregnancy, a woman should be tested for toxoplasmosis;
- strengthening the body's defenses ( regular hardening, proper nutrition, management healthy image life).
Cats are not the only carriers of toxoplasmosis among warm-blooded mammals. The risk group includes workers on livestock farms that breed cows, pigs, and rabbits. Poultry farm employees may also be at risk of infection, since more than 100 varieties of poultry are carriers of Toxoplasma, including domestic poultry: ducks, geese, chickens and quails. Veterinarians who regularly come into contact with sick animals must take precautions and thoroughly clean their hands, clothing and tools, since their risk of infection with Toxoplasma is considered to be maximum.
Other ways of infection for humans are:
- eating poorly cooked (or insufficiently processed, rotten, low-quality) meat of a sick animal;
- bites of mosquitoes, horseflies, gadflies and other insects;
- blood transfusion or organ transplantation from a person with toxoplasmosis;
- poor hygienic processing of fruit and vegetable products.
Very often among villagers you can find cases where people eat berries and greens unwashed, believing that products grown without the addition of chemicals and fertilizers do not cause any harm to the body. This is a misconception: if the berries are eaten by a bird with toxoplasmosis, the probability of infection for a person will be more than 60%.
Congenital form of the disease: symptoms and treatment
This is the most dangerous type of toxoplasmosis, which develops during fetal development. The infection enters the general bloodstream and placental tissue through the bloodstream of the sick mother, causing severe developmental abnormalities, and in severe cases, the death of the child. If a pregnant woman has been diagnosed with toxoplasmosis, the probability of infection of the fetus will be at least 35%. Doctors give the most favorable prognosis if the infection occurred after 28-30 weeks of gestation, when all vital organ systems have already been formed.
If Toxoplasma reaches the fetus in the first or second trimester, the pregnancy most often ends unfavorably. The consequences of infection during these periods may be:
- dropsy of the brain (hydrocephalus) – accumulation of cerebrospinal fluid in the ventricles of the brain;
- inflammation of the posterior space of the eyeball with simultaneous damage to the retina and the lining of the blood vessels (chorioretinitis);
- mental retardation.
The disease does not manifest itself clinically and is discovered accidentally during a comprehensive examination of the child. To diagnose toxoplasmosis during pregnancy, amniocentesis is used - the study of amniotic fluid by puncturing the amniotic membrane. If the diagnosis is confirmed, the doctor may recommend induced termination of pregnancy, since children infected before 20 weeks of gestation are often born with severe defects and deformities and live no more than 5 years.
Note! If a woman has had toxoplasmosis once, her body produces specific antibodies that protect her and future children from repeated infection. This means that there is no risk of contracting Toxoplasma even after one unsuccessful pregnancy in the future.
How to treat?
To prescribe the correct treatment for a pregnant woman, it is necessary to find out whether the infection has reached the fetal tissues or not. This can only be determined by puncture of the amniotic membrane. The procedure is quite dangerous and is associated with certain risks, including spontaneous abortion, so the attending physician must decide on its advisability, taking into account all possible risks.
If the infection is determined only in the mother, the woman is prescribed “ Spiramycin" This is a potent antibiotic from the macrolide group with antibacterial and bacteriostatic activity against Toxoplasma gondii. The active substance does not have teratogenic properties and does not accumulate in fetal tissues, so its use is considered relatively safe during pregnancy. In this case, spiramycin can be excreted into breast milk, and if treatment is necessary for nursing women, lactation should be stopped.
You need to take Spiramycin 1 tablet 3 times a day. The minimum duration of therapy is 5 days. The maximum course of treatment should be selected and prescribed by a doctor.
If amniocentesis reveals infection of the fetus, therapy is carried out according to the scheme given in the table (strictly after the twelfth week of gestation).
| Drug name | Image | How to use? |
|---|---|---|
| The initial dose is 2 tablets per day, followed by a reduction to 1 tablet per day. The duration of therapy is determined by the doctor |
||
| 1 g per day for 30 days |
||
| The daily dosage is calculated by the formula: 150 mg * kg of weight. The maximum amount of sulfadiazine per day should not exceed 4 g. |
Important! If infection of the fetus was detected in the first trimester, it is recommended to terminate the pregnancy.
Acute infection: how does it manifest and how to treat it?
Acute toxoplasmosis has fairly pronounced symptoms, which allows timely measures to be taken to treat the underlying disease and prevent associated complications. In almost all cases of acute Toxoplasma infection, the patient develops a fever. If a febrile syndrome occurs against this background, the temperature can reach 39° and higher. Upon palpation, an enlargement of the spleen and liver may be detected: this picture is typical for some infectious diseases, for example, typhus or mononucleosis, so it is important not to self-medicate and consult a doctor in time, who will carry out a differential diagnosis and make the correct diagnosis.
The infection very quickly enters the systemic bloodstream and spreads throughout the body, affecting the nervous system, organs of vision, digestive tract, so other symptoms of acute toxoplasmosis may be:
- vomit;
- complete refusal to eat due to severe nausea;
- numbness of the limbs;
- cramps of the calf and other muscles;
- muscle paralysis;
- enlarged lymph nodes;
- general weakness and decreased performance.
The most unfavorable prognosis is for forms of toxoplasmosis that affect the heart muscle. Such patients may complain of lack of air, shortness of breath, heaviness and compression in the chest, and changes in heart rhythm. When the visual system is damaged, visual acuity decreases and painful sensations appear in the eye sockets.
Basic and auxiliary therapy
The mainstay of treatment for toxoplasmosis is antibiotics. The drug of choice for the treatment of uncomplicated forms of infection is Spiramycin. It is quite well tolerated and allows you to quickly cope with inflammation and prevent possible complications. If the patient’s condition is assessed as consistently unsatisfactory, the drugs listed in the table may be included in the treatment regimen, but only after the necessary diagnostic measures have been carried out, the main of which is a blood test for the presence of antibodies and specific immunoglobulins.
Antibiotics for the treatment of acute toxoplasmosis
| Drug name | Image | How to use? | Duration of treatment |
|---|---|---|---|
| 2 tablets 1 time per week. If the disease is complicated by damage to the central nervous system, the drug must be combined with Spiramycin (recommended dosage for adults - 3 g) | 4 to 6 weeks |
||
| 1-2 suppositories per day deep into the vagina | At least 10 days |
||
| 150-450 mg every 6 hours or by injection 300 mg 2 times a day | Individually |
To restore normal intestinal microflora, the doctor may prescribe drugs from the group of prebiotics or lactobacilli (“ Acipol», « Bifiform», « Bifidumbacterin"). Women are recommended to simultaneously undergo a short prophylactic course of treatment with vaginal suppositories to prevent bacterial vaginosis, which often develops against the background of Toxoplasma infection and antibiotic use. Children can be given the drug " Normobakt" It comes in the form of white chocolate-flavored bears; the daily dosage is 1-2 figures.
People with reduced immunity may be prescribed immunomodulators, since it is the activity of immune cells that plays a major role in the treatment of infections caused by Toxoplasma. The drugs in this group are:
- "Cycloferon";
- "Ergoferon";
- "Amiksin";
- "Kagocel";
- "Arbidol";
- "Polyoxidonium".
Note! Any treatment regimen for acute or chronic toxoplasmosis is supplemented by taking folic acid (vitamin B 9). The dosage is calculated individually and can be up to 200 mg to 4-5 g per day.
Video - All about toxoplasmosis
Treatment of toxoplasmosis in patients with HIV infection and AIDS
HIV-infected patients are the main group of patients whose survival prognosis against the background of Toxoplasma infection is extremely unfavorable. The mortality rate from this disease against the background of immunodeficiency pathologies is about 33%, so it is important to promptly examine this group of patients. For the treatment of toxoplasmosis in patients with HIV and AIDS, the drug of choice is “ Atovaquone» (« Mepron"). The drug is slowly absorbed into the blood when administered internally, but the bioavailability of the active substance increases with the release of gastric juice and digestive enzymes, so it is recommended to take the medicine with meals.
In some cases, Atovaquone can be used concomitantly with other antibacterial and antiprotozoal drugs, for example, " Rifampicin"and tetracycline antibiotics, but the condition of patients when using such treatment regimens should be monitored by a doctor.
- Insufficient compliance or complete absence of hygiene rules when in contact with pet feces (cleaning the pet's litter box, getting feces particles on household items).
- Eating thermally poorly processed meat of an infected animal (in most cases, pork and lamb), as well as animal products - eggs, milk.
- During a blood transfusion, infection can come from a sick person.
- Transplantation of internal organs from an infected person.
- In utero, from a sick mother to the fetus.
Toxoplasmosis is transmitted by breastfeeding only if there are bleeding cracks and wounds on the nipples, as well as when the disease is in the acute stage.
There are several main and most common forms of toxoplasmosis. They differ in the signs of the course of the disease and the location of the lesion.
Symptoms of acute toxoplasmosis are the following:
- body temperature reaches 39 degrees;
- lymph nodes enlarge, especially in the axillary region;
- weakness, fatigue, apathy;
- pain in muscles and joints;
- The abdominal organs (liver, spleen) enlarge, so pain of varying intensity is felt.
Toxoplasmosis of the brain leads to inflammation of the brain, the following symptoms appear:
- headaches, dizziness;
- loss of sensitivity in certain areas of the body (most often the limbs);
- feeling of goosebumps crawling all over the body;
- paralysis of limbs;
- A serious condition is when a person falls into a coma.
The child is recognized by the following manifestations:
- inflammation of the retina, which leads to complete blindness of the baby;
- impaired functioning of the hearing organs, which can lead to deafness;
- jaundice;
- an increase in the size of the digestive organs (the liver and spleen are especially affected);
- the newborn's head may be abnormally large or small;
- there is a delay in physical and mental development.
- pain, pain in the eyes;
- visual impairment: double vision, fog, flashes;
- complete blindness.
Characterized by periods of exacerbation and remission. An exacerbation of the chronic stage of the disease is indicated by a slight increase in body temperature, pain in muscles and joints, problems with stool in the form of constipation or diarrhea, and heart rhythm disturbances. Inflammatory diseases of the organs of vision, as well as problems associated with the endocrine system, are of concern.
Laboratory diagnostics
- If a group of IgM antibodies is detected, this means that the infection occurred quite recently and the disease is in an acute stage.
- If the body has coped with the infection on its own or the disease is in a chronic stage, IgG antibodies are detected.
- The duration of infection is indicated by the avidity (the ability of human antibodies to bind to foreign microorganisms) of antibodies.
If a pregnant woman takes the test and IgM or IgG antibodies are detected, then she needs to take an IgG avidity test. At rates above 40%, the threat to the fetus is minimal. If avidity is low, the test is repeated after 3-4 weeks.
Sometimes additional studies such as EEG, ultrasound, X-ray, and tomography are performed. Biopsies of various tissues from affected amniotic fluid may be taken from pregnant women.
Therapeutic measures
The following medications are used during treatment for toxoplasmosis.
- Pyrimethamine is. It should not be treated in children under 2 months of age, nor should it be taken by pregnant women in the first trimester. Take the drug in cycles with an interval of 5-7 days. The initial dosage for an adult is 50 mg per day and then reduced.
- Sulfadiazine is an antimicrobial agent in tablet form. The initial dosage is approximately 3 g per day, then gradually decreases. Do not administer to pregnant women and children under 3 months.
- Clindamycin belongs to the group of broad-spectrum antibiotics. Not prescribed for pregnant women and children under 3 years of age. Intramuscularly prescribed 300 mg twice a day. If the medicine is prescribed in tablet form, then give one capsule 4 times a day.
- Prednisolone. This hormonal drug, which is most often used during the treatment of the ocular form of toxoplasmosis. It is not recommended for use during pregnancy, or when treating children under 12 years of age. The drug in tablet form is prescribed at 20-30 mg per day.
- Spiramycin. This is an antibacterial drug that is available in the form of tablets and solution for intravenous administration. The product is approved for use in: Adults are prescribed 2-3 tablets per day.
- Doxycycline is a broad-spectrum antibiotic. Available in capsules and ampoules. Not prescribed for pregnant women and children under 8 years of age. On the first day of treatment, 200 mg of the active substance is usually given.
- Metronidazole is a broad-spectrum antibacterial and antiprotozoal agent. Prescribe 250 mg twice a day. The course of treatment is a week.
Almost all of the above drugs lead to a deficiency of folic acid in the body. The brain begins to suffer, so drugs containing this microelement are prescribed in parallel.
Additional groups of medications that are prescribed for toxoplasmosis include the following.
- At the same time, immunomodulatory drugs are prescribed - Likopid, Taktivin, Cycloferon, Thymogen.
- Antihistamines - Suprastin, Diazolin, Tavegil.
- Systemic enzyme therapy drugs are prescribed - Wobenzym, Flogenzym.
- Probiotics and prebiotics that restore damaged intestinal microflora.
Traditional medicine can be used to treat toxoplasmosis.
Prevention, which mostly applies to pregnant women, will help avoid infection. You should stay away from cats, do not interact with soil and sand, and keep your hands clean.