A Case of Toxoplasmosis Mimicking Influenza and COVID-19: Diagnostic Pitfalls and Management Challenges

Toxoplasmosis, caused by Toxoplasma gondii, is a globally prevalent parasitic infection that often presents with nonspecific symptoms, making diagnosis challenging, especially in immunocompetent individuals.

We report a case of a 22-year-old immunocompetent male presenting with cervical lymphadenopathy, fever, and flu-like symptoms, initially misdiagnosed as influenza or COVID-19. Despite symptomatic treatment, his condition worsened. Serological testing confirmed acute toxoplasmosis (IgM: 6.64 IU/ml; IgG: 44 IU/ml). Ultrasonography showed hypoechoic cervical lymph nodes, consistent with lymphadenopathy. Treatment with azithromycin, pyrimethamine, and folinic acid for 10 days led to complete symptom resolution.

This case highlights the importance of considering toxoplasmosis in the differential diagnosis of cervical lymphadenopathy, especially in patients with persistent flu-like symptoms. Early serological testing and imaging are crucial for accurate diagnosis and timely intervention. The rapid clinical improvement observed underscores the effectiveness of antiparasitic therapy in immunocompetent individuals. Greater clinician awareness of the diverse presentations of toxoplasmosis is essential to prevent misdiagnosis and optimize patient outcomes.