Introduction: Toxoplasmosis refers to acute necrotizing inflammation of the retinal choroid caused by Toxoplasma gondii infection, which can be divided into congenital and acquired according to its etiology, of which congenital is mainly caused by intra-fetal infection, accounting for the vast majority of the disease, and acquired is mainly caused by external environmental infection. Patients may have decreased vision, black shadows fluttering in front of the eyes, eye pain, white pupils, strabismus and other eye symptoms, as well as fever and lymphadenopathy. Currently, drug therapy is predominantly used, and its prognosis depends on the immune function of the host.
First, sick patients need to know more about the cause of the disease, which should be paid attention to
(1) Review of etiology
The main cause of the disease is Toxoplasma trichondria infection, which can be divided into two types: congenital and acquired, congenital intra-fetal infection, which is the main infection route of the disease, and acquired is mostly infected by the external environment. Immunocompromised or immunodeficient, close contact with cats infected with Toxoplasma gondii, and consumption of food and water contaminated with Toxoplasma gondii are risk factors for the disease.
(2) The root cause
1. Congenital infection: pregnant women can be transmitted to the fetus through the placenta after infection with Toxoplasma gondii, which is the main route of infection of toxoplasmosis.
2. Acquired infection
Acquired toxoplasmosis is a disease that occurs after the human body is infected by the external environment, mainly due to the consumption of food containing toxoplasma gondii oocysts, cysts or water through the digestive tract, can be infected by close contact with animals carrying pathogens, or through skin or mucous membranes contact with contaminated water or soil. In addition, blood transfusions or organ transplants can also cause infections.
(3) Hazard factors
People with weakened immune systems are at much higher risk of developing ocular toxoplasmosis than in normal populations, such as the elderly, those who inject topical corticosteroids or undergo systemic therapy or take immunosuppressants for a long time, and people with AIDS. Close contact with felines; eating food and water contaminated with Toxoplasma gondii.
Second, what are the symptoms of patients after illness? The more you know, the more you prevent it
(1) Review of symptoms
Patients with this disease may have decreased vision, dark shadows in front of the eyes, eye pain, leukotic pupils, strabismus, systemic symptoms such as fever, lymphadenopathy, congenital toxoplasmosis ocular manifestations are mostly congenital malformations caused by embryonic inflammation, acquired systemic toxoplasmosis infection and ocular symptoms are rare. Complications such as concurrent cataracts, secondary glaucoma, vitreousemia, retinal detachment, and blindness can also occur.
(2) Characteristic symptoms
1. Visual impairment
The clinical manifestations of pediatric toxoplasmosis are not obvious, and vision loss may occur in symptomatic patients. Adult toxoplasmosis usually presents as floaters, with dark shadows fluttering in front of the eyes or associated low vision.
2. Eye pain: its infection symptoms are necrotizing retinitis or retinal choroiditis, and eye pain may occur.
3. White pupils
Congenital toxoplasmosis in the eye is mainly due to congenital malformations caused by inflammation in the embryonic stage, which can manifest as white pupils caused by cataracts.
4. Strabismus: the eye manifestations of congenital toxoplasmosis are mostly deformities caused by inflammation caused by embryonic inflammation, which can lead to strabismus.
(3) Concomitant symptoms
Acquired Toxoplasma gondii infection is rare and may present with systemic symptoms such as fever and lymphadenopathy for unknown cause.
1. Concurrent cataracts: complicated cataracts may be caused by lens metabolism disorders caused by inflammation of the choroidal retina, which is manifested as decreased vision.
2. Glaucoma: it can cause aqueous humor circulation disorders due to inflammation of the choroidal retina, causing glaucoma, which is manifested by decreased vision, eye pain, and increased intraocular pressure.
3. Glass hemostasis: it can cause retinal hemorrhage due to inflammation of the choroidal retina, resulting in the production of glass blood volume, which is manifested as decreased vision and black shadows in front of the eyes.
4. Retinal detachment
Retinal hemorrhage can be caused by inflammation of the choroidal retina, resulting in exudative retinal detachment, manifested by decreased vision and fluttering black shadows in front of the eyes.
5. Blindness
Patients with congenital eye toxoplasm are more severely treated or relapsed, and patients with congenital eye toxoplasm are blind due to aggravation of inflammatory lesions of the fundus, resulting in concurrent cataracts, secondary glaucoma, vitreous blood, retinal detachment and blindness.
Third, patients need to be treated well to avoid aggravation of their own diseases
(1) Expected inspection
When the patient has decreased vision, black shadows in front of the eyes, eye pain, white pupils, strabismus and other eye symptoms, and systemic symptoms such as fever and lymphadenopathy, it is necessary to seek medical treatment in time. At the time of consultation, the doctor will first perform a corresponding eye examination on the patient to determine whether there are abnormal signs. Fundus examination, blood routine, pathogen examination, serological examination, etc. may then be recommended to confirm the diagnosis and assess the severity of the condition.
(2) Analysis principles
Features of fundus lesions, examination of pathogens, and serological tests, such as indirect fluorescent antibody testing (IFAT), can help diagnose disease and assess severity. When the diagnosis is confirmed, doctors need to rule out choroidal tuberculoma, cytomegalovirus infection.
(3) Differentiated diagnosis
1. Tumors of choroidal tuberculosis
Tuberculosis tumors in the choroidal region due to infection with Mycobacterium tuberculosis, yellow and white lesions can be seen under the fundus, and the test for tuberculin is positive, but the serology of Toxoplasma is negative. Mycobacterium tuberculosis test and toxoplasma gondii serum test can be differentiated from gondosis.
2. Cytomegalovirus infection
Ocular symptoms caused by CMV infection are prone to immunocompromise, especially in AIDS patients, where yellow-white localized retinal necrosis occurs under the fundus, white sheaths appear in adjacent retinal blood vessels, and old lesions have pigment hyperplasia. Complement binding tests and patient fluid and urine tests can be distinguished from arch lesions.
Fourth, do a good job in timely prognosis, can be better treated, the body can also recover better
(1) Prognosis review
The prognosis of the disease depends mainly on the host's immune response. After treatment, most patients have better vision recovery, but patients with AIDS or patients with active macular degeneration, retinal vascular obstruction, and retinal vascular bridges tend to have a poorer prognosis. This disease can affect the patient's visual function, cause vision loss, and may even be blind, seriously affecting the quality of daily life of patients. Current treatment of the disease can only limit the reproduction of Toxoplasma gondii in active retinitis, cannot contain radical cure, and therefore there is a risk of recurrence. Retinal defects are a common sequelae.
(2) Disease hazards
Acute infection of toxoplasma gondii in pregnant women can be transmitted to the fetus through placental hematogeny, affecting fetal development. This disease can affect the patient's visual function, cause vision loss, and even the possibility of blindness, which seriously affects the quality of daily life of patients. The disease can cause visual field defects.
(3) Repeated diseases
In people with AIDS, irregular anti-insect therapy often leads to a recurrence of the disease. Both pregnancy and cataract surgery increase the risk of relapse of toxoplasmosis. Patients without active toxoplasmosis retinal scarring are usually at low risk of recurrence. The interval between episodes is prolonged, the age of initial onset increases, and the recurrence rate decreases.
(4) Preventive measures
1, pay attention to daily hygiene, cats should be raised at home, to avoid cats from the digestive tract through the contaminated food is infected and spread. People who keep pets should wash their hands carefully after contact with animal feces.
2, pay attention to dietary hygiene, cooked meat can be eaten, vegetables, melons and fruits should be fully cleaned before eating, do not eat raw food, do not drink raw water.
3. During pregnancy, contact with pets and their excrement should be avoided, especially cats and cats are the terminal hosts of Toxoplasma gondii and are the main source of infection of Toxoplasmosis.
Conclusion: Patients should maintain a good attitude in their daily lives, insist on exercising, and develop good eating habits. Take the initiative to cooperate with the treatment, follow the doctor's instructions to take the drug, and review it regularly, so that the doctor can understand the efficacy and adjust the treatment plan in time. Many times, our body may not be able to show symptoms in time, but after symptoms, we need to check in time.