Toxoplasma infection
Introduction
Introduction Toxoplasmosis is a zoonotic parasitic disease caused by Toxoplasma gondii. Widely distributed throughout the world. Divided into two types of congenital infections and acquired infections. These two types are mostly asymptomatic latent infections in the human body, and generally do not cause latent infections of severe symptoms, and generally do not cause serious sequelae. However, the clinical manifestations of the affected person are extremely complicated, often due to different organs of the infection, mainly invading the eyes, brain, lymph nodes and heart, causing chorioretinitis, hydrocephalus, small head deformity, eyeballs and brain calcification. Wait.
Cause
Cause
Causes:
The disease is closely related to pregnancy. According to reports, the infection rate of toxoplasma in pregnant women is 0.26% in Tokyo, 0.8% in Paris, and 0.36% in New York. The infection rate of the fetus can reach 34-40%. It is speculated that the infection rate of pregnant women and fetuses in China will not be lower than this figure. After the mother is infected with toxoplasma during pregnancy, whether it is a dominant or latent infection, the fetus can be infected through the placenta, which directly affects fetal development and is teratogenic. Congenital toxoplasmosis has become the most serious disease in human congenital infections.
Acquired infection, mainly by oral transmission, cat feces can be infected after oral ingestion; in addition, cats, dogs, sheep, chickens almost have toxoplasma in the organs, all over-cooked dogs, drinking not Disinfected milk and raw eggs can also be infected, and blood donor blood containing a toxoplasma is introduced, and an example of infection of the toxoplasma after kidney transplantation is found.
Examine
an examination
Related inspection
Toxoplasma antibody assay for Mycobacterium tuberculosis gene detection (PCR) direct smear test
Clinical manifestations:
Only a small percentage of clinical signs appear after infection with toxoplasma, most of which are subclinical. Human infection with toxoplasmosis is a congenital symptom, especially in the 4 to 5 months of pregnancy, often causing miscarriage or stillbirth, even if the full-term delivery, the baby is often microcephaly, hydrocephalus, small eyeballs , cerebral calcium deposition, mental retardation, choroid and retinitis, hepatosplenomegaly, jaundice, hemorrhagic rash, etc., a small number of palmar rash, exfoliative dermatitis, hair loss and central nervous system symptoms.
Acquired toxoplasmosis, except for a few severe cases, generally mild symptoms, most of which are recessive infections, patients may not show any symptoms, only multiple organs in the acute phase, such as lymphadenopathy, meningitis, multiple muscles Inflammation, hepatitis, enteritis, retinitis, etc. In the skin and mucous membranes, broad bean mouth ulcers, subcutaneous nodules, macules, papules, blisters, bleeding spots, scaling, and cleft palate may occur. Topi et al. divided the clinical manifestations of active patients into four subgroups:
1 chronic pruritus or subcutaneous nodular type: the lesion contains toxoplasma, treated with corticosteroids is ineffective.
2 dermatomyositis syndrome type: there is typical dermatomy syndrome, but serum enzyme tests are normal, muscle biopsy can be found in the toxoplasma.
3 polymorphic rash type. The skin manifests as pruritus, chronic urticaria, polymorphous erythema, ring-shaped eccentric erythema, limb vasculitis, and purpuric telangiectasia.
4 Patients with systemic lupus erythematosus and autoimmune diseases are prone to toxoplasmosis or prolonged infection of latent toxoplasmosis when taking prednisone immunosuppressive agents for a long time. Why the skin can have such different symptoms, which is closely related to the immune status of the body.
Diagnosis
Differential diagnosis
Differential diagnosis of toxoplasmosis infection:
Congenital toxoplasmosis should be differentiated from other diseases in TORCH syndrome (rubella, cytomegalovirus infection, herpes simplex and toxoplasmosis). In addition, there is a need for syphilis, Listeria or other bacterial and infectious encephalopathy. Identification of fetal polycythemia, sepsis, infectious mononucleosis, lymph node tuberculosis, etc. Mainly rely on pathogens and immunological examinations.
1. Congenital cytomegalovirus infection
Congenital toxoplasmosis infection, performance and prognosis are similar to CMV infection, mainly relying on laboratory tests for differential diagnosis.
2. Other pathological jaundice
Mainly rely on the performance characteristics of clinical systemic organ damage and laboratory identification.
3. Other meningoencephalitis
Clinical features of laboratory damage and identification of laboratory tests.
