In an immunocompetent patient, the most likely presentation of Toxoplasma gondii infection is:

• A. Mono-like illness with cervical LAD
• B. Severe encephalitis
• C. Meningitis with photophobia
• D. Jaundice and hepatosplenomegaly

Answer: (A)

In healthy individuals, primary Toxoplasma gondii infection most commonly causes a mild, self-limited illness that resembles mononucleosis, with fever, malaise, and tender cervical lymphadenopathy—often the posterior nodes. This reflects a competent immune system containing the parasite while still producing systemic symptoms. Severe encephalitis is a concern mainly in people with weakened cell-mediated immunity, such as advanced HIV/AIDS or immunosuppressive therapy, not the typical presentation in an immunocompetent patient. Meningitis with photophobia is more typical of other meningitic processes rather than the common toxoplasma presentation in a healthy person. Jaundice and hepatosplenomegaly aren’t characteristic of the usual acute toxoplasmosis in someone with normal immunity; they can appear in disseminated or congenital infections, but they’re not the classic scenario here. Therefore, the most likely presentation is a mono-like illness with cervical lymphadenopathy.