Outlier adenic toxoplasmic syndrome

Abstract

Introduction: Adenopathies, lymphadenopathies or lymphadenomegalies are common causes of pediatric consultation. These nosological entities can range from transient benign infections to malignant processes such as lymphoma, tumor metastases, and others.

Objective: Describe a clinical case with an adenic syndrome that from the semiological characteristics suggested an onco-proliferative process and the results of the complementary studies confirmed an infectious process caused by Toxoplasma gondii.

Case presentation: 11-year-old female adolescent, eutrophic, with a personal health history. She was admitted at "William Soler" University Pediatric Hospital after presenting volume increase in the right lateral cervical region. An adenopathy of approximately 2 x 3 cm in diameter, hard, motionless, non-painful, with no signs of inflammation, not attached to deep planes was found at the physical examination; in the evolution, another adenopathy appeared in a lower right cervical position, with equal characteristics. Blood counts, globular sedimentation rate, C-reactive protein, transaminases, glycemia, total proteins, albumin, triglycerides, cholesterol, tumor markers, ultrasound, chest x-rays, serology for anti-cytomegalovirus antibodies, human immunodeficiency virus and Toxoplasma gondii tests were indicated. Biopsy was also performed for study by pathological anatomy and molecular biology. The case was concluded as an adenic toxoplasmic syndrome.

Conclusions: In adolescent patients with cervical adenopathies, regardless of size, evolution time and consistency, differential diagnosis for Toxoplasma gondii infection should be made, taking into account that adenopathies caused by this parasite may have some characteristics similar to those caused by onco-proliferative processes that may occur at this age.