Pediatria pre prax 3/2001
Specifika nepřímé diagnostiky toxoplazmózy a lymeské boreliózy u dětí
SPECIAL FEATURES OF INDIRECT DIAGNOSTICS OF TOXOPLASMOSIS AND LYME BORRELIOSIS IN CHILDREN Toxoplasmosis is an infectious disease caused by a parasitic protozoon Toxoplasma gondii. In spreading of infectious agent the cat plays an important role. A routine diagnostics of toxoplasmosis is based on serological tests. Complement-fixing reaction and immunoenzymatic methods (mainly ELISA) are used. In its acute phase, primary T. gondii infection is characterized by a rapid increase of IgA and IgM, the level of IgG increases slowly. Subsequently, the titres of immunoglobulins A and M gradually decrease, IgG remains increased (chronic toxoplasmosis). Presence of isolated IgG antibodies (mostly in low levels) is typical for latent toxoplasmosis. There is a possibility of reactivation of latent toxoplasmosis and reinfection by the T. gondii strain with different antigenic characteristic. A special attention should be given to the question of toxoplasmosis in pregnancy and to diagnostics of infection in newborn. Lyme borreliosis (LB) is mostly a tick-borne inflammatory disease. In the Czech Republic, Borrelia afzelii and B. garinii are mainly seen as etiologic agents. Children playing in environment where ticks occur are in high risk of infection. The diagnostics of LB is based on indirect methods (ELISA and Western blot) determining borrelial antibodies in serum, cerebrospinal and synovial fluids. Humoral reaction to the infection is individually highly variable. The presence of IgG and IgM antibodies is detected. The results of serological tests can not be evaluated separately. The determination of diagnosis must be above all based on patient´s medical history and clinical picture. If indicated, it is suitable to detect the etiologic agent using direct methods. Key words: toxoplasmosis, Lyme borreliosis, indirect diagnostics
