HomeAnswersOtolaryngology (E.N.T)toxoplasmosisWhat is the reason for my recurrent throat pain and swollen lymph nodes?

Does toxoplasmosis and acid reflux explain all my symptoms?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At September 7, 2017
Reviewed AtJuly 2, 2023

Patient's Query

Hello doctor,

I am sorry as this will be a bit long. I will try to explain concisely. I am a 40 year old male, and I weigh 100 kg and 1.85 m tall. I have toxoplasmosis. Last year, I had a weird throat ache, like a persistent itch on the upper side of my left palatine tonsil. It is hard to describe, but it felt like having a stray bit of food stuck there. Over the course of a few weeks, it grew more and more painful, with pain radiating into the left ear and swollen lymph nodes on left side of my neck. So, I went to my doctor. He noticed an irritation there, and said it could be gastric reflux, and prescribed Esomeprazole, which had no effect. We tried some antibiotics, again without result. Other symptoms were mild fever and fatigue.

So, after a month, I went to see an ENT specialist. This is when the fun starts. He examined my throat with an endoscope, saw nothing, and said it was gastric reflux. I told him I was a smoker, and he replied that for my peace of mind, we could take some time to figure it out and scheduled an endoscopic lung examination. A procedure which requires general anesthesia, to probe a bit that does not hurt and without doing any kind of non-invasive exam like an x-ray first. I did not do it. However, I did the other exams he wanted like radiography of left sinus and echography of sub-mandibulary gland, both the tests found nothing.

The symptoms receded without treatment in the same way they had come, and by two months, everything was gone. And by the end of last year, that itch in my throat came back just like before, and then it became very painful again, with the same scenario. The symptoms were swollen lymph nodes on left side of the neck, mild fever (38°C), and fatigue. I also got muscle aches in various places, mostly left arm and left side of the chest muscles. So during the start of this year, I went back to see that specialist. He looked at my throat again, and he found nothing. So, he told me maybe it is psychosomatic, but I should still do an MRI just in case.

I went back to my doctor and started from scratch. We did a throat swab, which was normal. The blood test showed toxoplasmosis IgG 2.8 IU/mL and toxoplasmosis IgM 3.25 IU/mL. Everything else was normal, and I do not have HIV, Lyme, hepatitis A, B, or C, and thyroid hormones are normal. So, I have toxoplasmosis, which according to my doctor, explains all the symptoms except the throat ache, which is very worrying. He says I should still do the MRI. I went to see another ENT who said toxoplasmosis also explains the throat ache, and I should not worry. He told me not to do the MRI. He also told me I had reflux, so I stopped worrying. Does toxoplasmosis and acid reflux explain all the symptoms? Should I do that MRI? Or perhaps do other tests?

I smoked from age 25 until last year. I quit for six months, then smoked again for six months, and now just quit again, hopefully for good. Also, I used to drink alcohol in unreasonable quantities at night with friends, but I stopped that too. Since then, I have learned that cigarette and alcohol are a risk of amygdala cancer, but I probably have not got that. Still, it is a good reason to get rid of unhealthy habits. I gained 20 pounds last year after quitting smoking. And lost them with a bit of cycling and a little diet. Right now, I am in a general good shape except a bit of a stomach. When I used to cycle a lot, my rest heart rate was 55 bpm. I had too much work recently to exercise properly, so I am around 70 to 75 bpm right now, and my blood pressure is normal. Thank you for your time.

Hi,

Welcome to icliniq.com.

Toxoplasmosis has a sore throat as one of its presenting complaints. So, do not worry about the sore throat as well as rest of the symptoms. They are due to toxoplasmosis only as your tests also show positive for antibodies. An MRI need not be done until you have any complaints pertaining to that. Hence, do not go for it now. You can get a FNAC (fine needle aspiration cytology) done from the swollen lymph nodes in the neck. No other tests are required. Please tell me what medicines have you been taking so far? Any further questions are always welcome.

Patient's Query

Hi doctor,

Thank you very much. That is reassuring. The pain is not really in the throat (down where the vocal folds are) but at the rear of the left sinus (inside the nose) and on top of the left amygdala right next to the glottis. Sorry, I am not a doctor, this is hard to explain. It feels a bit like the end phase of a cold when the inside of the nose hurts but not the back of the throat. Right now, the pain is slowly fading, so it is fine. But it lasted a month, then disappeared for two months, then came again for a month, then it is disappearing again. I hope it is not going to come back in two months.

My lymph nodes were swollen and painful two weeks ago, but have returned to normal slowly since then. Right now, it is almost completely gone. I had echography in this area, and they found no tumors nor anything suspicious. Do you think FNAC is necessary? I am just taking Ibuprofen, besides that, nothing at all. Thanks again.

Hi,

Welcome back to icliniq.com.

Thanks for contacting again.

You should continue taking antacids for a few days. Also, consult your physician regarding anti-toxoplasma antibiotics. If nodes have regressed, then no need for FNAC.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Priyanka Aggarwal
Dr. Priyanka Aggarwal

Audiology

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