Vol.98 No.3 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 98 No. 3 March 2005
Toxoplasmic Lymphadenopathy: A Case Report
Naohiro Wakisaka, Tomokazu Yoshizaki and Mitsuru Furukawa
(Kanazawa University)
Toxoplasma gondii is a protozoan parasite that infects up to a fourth of the Japanese population. Infection is mainly acquired by ingestion of food or water that is contaminated with oocysts shed by cats or by eating undercooked or raw meat containing tissue cysts. Toxoplasma gondii primary infection is asymptomatic in most patients. The most typical clinical manifestation is isolated cervical lymphadenopathy.
We report a case of chronic right neck lymphadenopathy caused by infection with toxoplasma gondii. A 16-year-old previously healthy male visited our department for evaluation of chronic cervical lymphadenopathy. Physical examination revealed multiple painless lymph nodes with a size of approximately 1.5 cm in the right submandibular region. The first histological examination revealed stellate granulomas with central necrosis, which is compatible with cat scratch disease (CSD). Sixteen months later, submandibular lymphadenopathy appeared again. The second histological examination was probable toxoplasmosis, which was confirmed with serological tests. Immunoglobulin (Ig) M and IgG antibodies to toxoplasma gondii were detected, which revealed elevated titers of both IgM and IgG, of 20 and 1,280, respectively. Both of dye test and indirect latex agglutination test for toxoplasma gondii were 1,024, respectively. The patient was thought to be infected with toxoplasma gondii following CSD. He was successfully treated with Acetylspiramycin (900 mg/day) for four weeks without any evidence of recurrence, or side effect.
Key words : toxoplasmosis, cat scratch disease, serological tests