Pathogenesis
1 致病因子
。1)蟲株毒力 RH株(強毒株) Beverley株 (弱毒株)
(2)機體免疫狀態(tài) (屬Opportunistic protozoiasis)
2 致病機制
。1)tachyzoites 導(dǎo)致組織急性炎癥和壞死
(2)bradyzoites 是慢性感染的主要形式,cyst擠壓器官組織,破裂后刺激機體發(fā)生變態(tài)反應(yīng),形成肉芽腫,纖維化。
3 臨床分類
。1)先天性弓形蟲病
發(fā)生于初孕婦女,經(jīng)胎盤感染胎兒,可致流產(chǎn)、早產(chǎn)、畸胎或死產(chǎn)。懷孕早期感染畸胎發(fā)生率高。
主要累及大腦和眼,如腦積水、腦鈣化、視網(wǎng)膜脈絡(luò)膜炎和精神、動物障礙為典型癥候。
Hydrocephalitis
intracraninal calcification
Chorioretinitis
。2)獲得性弓形蟲病(多為隱性感染,屬機會致病原蟲,AIDS等病時轉(zhuǎn)為急性重癥,惡化)(1) 淋巴結(jié)腫大 患者淋巴結(jié)腫大,變硬,有橡皮樣感,伴有長時間低熱,疲倦,肌肉不適等。
(2) 腦炎、腦膜炎、癲癇和精神異常等中樞神經(jīng)系統(tǒng)病癥
(3) 眼病,較先天性弓形蟲病少見,有些不先天性感染但到成年后發(fā)作所致。
Photograph of fundus. Showing a heavily pigmented central choroidal lesion in a young person due to acquired toxoplasmosis. The whitish patches inside the lesion are areas where the sclera is exposed due to the necrosis of the retina. A sharply demarcated lesion, as seen in this photograph, is typical of both acquired and congenital toxoplasmosis. However, in some cases a more diffused lesion may be observed.