A Diagnostic Challenge: Toxoplasmosis Masquerading as Tonsillar Neoplasm

Area of Science:

• Infectious Diseases
• Otolaryngology
• Pathology

Background:

• Toxoplasmosis, a parasitic infection, typically presents with mild, flu-like symptoms in immunocompetent individuals.
• Oropharyngeal lesions and cervical lymphadenopathy are uncommon presentations of toxoplasmosis.
• Differential diagnosis of tonsillar neoplasms can be challenging with atypical infectious presentations.

Observation:

• A 28-year-old immunocompetent woman presented with a sore throat, unilateral neck pain, and otalgia.
• Clinical examination revealed an ulcerative oropharyngeal lesion and cervical lymphadenopathy, suspicious for malignancy.
• A tonsillectomy for suspected neoplasm showed inflammation, not cancer.

Findings:

• Serological testing confirmed a recent primary infection with Toxoplasma gondii.
• High IgM antibodies and low IgG avidity indicated acute infection.
• Histopathology of the tonsillectomy specimen revealed significant acute and chronic inflammation.

Implications:

• This case highlights the importance of considering toxoplasmosis in the differential diagnosis of oropharyngeal lesions, even in immunocompetent patients.
• Atypical presentations of toxoplasmosis necessitate thorough laboratory investigations, including serological testing for Toxoplasma gondii.
• Early and accurate diagnosis of toxoplasmosis can prevent unnecessary surgical interventions and guide appropriate treatment.