Baqiyatallah University of Medical Sciences Hospital Practices and Research 2476-390X 9 3 2024 09 20 A Case of Toxoplasmosis Mimicking Influenza and COVID-19: Diagnostic Pitfalls and Management Challenges 538 541 216225 10.30491/hpr.2025.505690.1469 EN Faride Khanabadi Department of Parasitology and Mycology, School of Medicine, Arak University of Medical Sciences, Arak, Iran 0000-0001-5259-2317 Farnood Ghanoon Department of Laboratory Sciences, Babol Branch, Islamic Azad University, Babol, Iran Hossein Torkashvand Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Mohammadhossein Asadidarbaghi Department of Radiology, Diagnostic Radiologist, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Bahareh Basirpour Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Mahdi Mosayebi Department of Parasitology and Mycology, School of Medicine, Arak University of Medical Sciences, Arak, Iran Seyedeh Shaghayegh Hosseini Department of Laboratory Sciences, Babol Branch, Islamic Azad University, Babol, Iran Taher Elmi Department of Parasitology and Mycology, School of Medicine, Arak University of Medical Sciences, Arak, Iran 0000-0002-4247-4445 Journal Article 2024 07 09 <strong>Background:</strong> Toxoplasmosis, caused by <em>Toxoplasma gondii</em>, is a globally prevalent parasitic infection that often presents with nonspecific symptoms, making diagnosis challenging, especially in immunocompetent individuals.<br /><strong>Case Presentation:</strong> 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.<br /><strong>Conclusion: </strong>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. https://www.jhpr.ir/article_216225_13f5b57540dc99e5aee9aff162a8652c.pdf