Cervical Toxoplasma Lymphadenitis in Immunocompetent Patients: A Report of Five Cases and Literature Review

Abstract

Toxoplasma gondii is a protozoan parasite that can cause cervical lymphadenopathy, particularly in immunocompetent individuals. Although often self-limiting and asymptomatic, it can clinically mimic conditions such as tuberculosis or lymphoma, leading to unnecessary invasive procedures or treatment. We report five cases of toxoplasma lymphadenitis confirmed by histopathological and serological evaluation. All patients presented with painless cervical lymph node enlargement and lacked systemic symptoms. Key histological findings included reactive follicular hyperplasia, epithelioid histiocytes, and monocytoid B-cell proliferation. Serological testing revealed positive Toxoplasma IgG in all cases and IgM in four. No patients required specific anti-toxoplasma therapy, and no recurrence was observed during follow-up. These cases highlight the importance of considering toxoplasmosis in the differential diagnosis of cervical lymphadenopathy. Recognition of its pathological and serological features is crucial for accurate diagnosis and preventing misdiagnosis and inappropriate management.