Toxoplasmosis as an unusual cause of massive lymph node enlargement

An immunologically competent adult with acquired toxoplasmosis presented with inguinal lymphadenopathy and associated lymphatic and venous obstruction. A diagnosis of toxoplasmosis was made by demonstration the presence of the trophozoite, and response to therapy, while satisfactory, was slow. Recrudescence of lymphadenopathy was associated with a change from reactive lymphadenitis to angioimmunoblastic lymphadenopathy. There was a dramatic improvement following local therapy and systemic corticosteroids and chlorambucil. The patient remains well.