An outbreak of acute eosinophilic myositis attributed to human Sarcocystis parasitism.

Arness, M K; Brown, Jason; Dubey, J. P.; Neafie, Ronald C.; Granstrom, David E.

doi:10.4269/ajtmh.1999.61.548

Cited by 106 publications

(99 citation statements)

References 12 publications

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“…infection was reported and involved 7 of 15 U.S. military personnel who had operated in rural Malaysia. 10 More recently, outbreaks of symptomatic acute muscular sarcocystosis in foreign travelers to Tioman Island, off the east coast of peninsular Malaysia were reported. 11,12 We report two symptomatic cases of acute muscular sarcocytosis in which S. nesbitti has been identified.…”

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confidence: 99%

Sarcocystis nesbitti Infection in Human Skeletal Muscle: Possible Transmission from Snakes

Lau¹,

Chang²,

Tan³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. Sarcocystis nesbitti is an intracellular protozoan parasite found as sarcocysts within muscle fibers of intermediate hosts (monkey and baboon). The definitive host is suspected to be the snake. We report two cases from a larger cohort of 89 patients who had fever, headache, and generalized myalgia after a trip to Pangkor Island, Malaysia. Sarcocysts were detected in skeletal muscle biopsy specimens by light and electron microscopy from these two patients. DNA sequencing based on the 18S ribosomal DNA region identified the Sarcocystis species as S. nesbitti. We also identified S. nesbitti sequences in the stools of a snake (Naja naja). Phylogenetic analysis showed that these sequences form a cluster with most of the other known Sarcocystis species for which the snake is a definitive host. We believe these two patients were likely to have symptomatic acute muscular sarcocystosis after S. nesbitti infection that may have originated from snakes.Sarcocystis species are an intracellular protozoan with a life cycle based on a prey-predator relationship in which various animal species serve as either intermediate or definitive hosts, respectively. Asexual development occurs in the intermediate host after ingestion of sporocysts produced by the definitive host and excreted in the feces. Ingestion of sarcocysts found in the muscles of the intermediate host by the predator definitive host completes the life cycle.1 Humans serve as the definitive hosts for Sarcocystis hominis and S. suihominis after eating improperly cooked, sarcocyst-infected meat from intermediate hosts (cattle and pigs, respectively). Furthermore, humans can also serve as accidental intermediate hosts for some Sarcocystis species of hitherto unknown origin. In these cases, it is assumed that humans became infected through food or drinks contaminated by sporocysts, resulting in skeletal muscle sarcocystosis. Human sarcocystosis is reported to be widely distributed. 361

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confidence: 99%

Sarcocystis nesbitti Infection in Human Skeletal Muscle: Possible Transmission from Snakes

Lau¹,

Chang²,

Tan³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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“…It indicates that muscular sarcocystosis may be a cause of eosinophilia. Sarcocystis might be an overlooked cause of unexplained eosinophilia and eosinophilic myositis (Arness et al, 1999;Abdul-Rahman et al, 2002). Tappe et al (2013) reported that eosinophilia is a hallmark of acute and not chronic disease.…”

Section: Discussionmentioning

confidence: 99%

“…Some of these are associated with parasitic infections as muscle sarcocystosis (Habeeb et al, 1996;Crum-Cianflone, 2008). Many cases have been recently reported and some are clinically diagnosed as eosinophilic myositis (Arness et al, 1999). Muscular sarcocystos is described in many parts of the world, 21% of the patients in Southeast Asia, 47% in U.S. military team in rural Malaysians, 19.8% in Malaysia, 60 cases in the United States and 26% patients in Iraq (Wong and Pathmanathan, 1992;Arness et al, 1999;Abdul-Rahman et al, 2002;Kiel, 2002;Al-Taee et al, 2009).…”

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confidence: 99%

“…Therefore, proper diagnosis of muscular sarcocystosis could relieve them from continuous pain and therapy side effects (Azab and El-Shennawy, 1992). So, there is rising demand for serological diagnosis of sarcocystosis (Arness et al, 1999). IFAT as a specific and sensitive serologic test was developed for its diagnoses (Al-Taee et al, 2009;Durate et al, 2003;Crum-Cianflone, 2008).…”

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Muscular Sarcocystosis and Non-Specific Rheumatic Diseases are growing Neglected Coming Challenge

Mandour¹,

Monib²,

Mahmoud³

et al. 2017

J. Adv. Parasitol.

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| Sarcocystosis is a zoonotic disease caused by coccidian/apicomplexan protozoa in humans and animals. The prevalence of muscular sarcocystosis among 100 patients with non-specific rheumatic diseases was determined. An indirect fluorescent antibody test (IFAT) using the Sarcocystis fusiformis antigen was used. The sero-prevalence among all examined patients was 52%. Patients with myositis have the highest percentage of positivity (39.5%). Statistical significance was between positive and negative cases in group A (non-specific rheumatic diseases) with highly significant results in the myositis subgroup. 39 out of 52 (75%) seropositive patients expressed eosinophilia (7-18%). There was no cross reaction with Toxoplasma positive serum. Muscular sarcocystosis may be an important cause of the non-specific rheumatic diseases especially myositis with increasing percentages over years in our locality. Further studies, for the source of infection, early diagnosis and treatment are necessary, as they remain unclear.

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“…The cysts contain many banana shaped bradyzoites of size ranging from 1-3μm. Other findings that can be seen in the muscle biopsy include myonecrosis, perivascular and interstitial inflammation, vasculitis and eosinophilic myositis [12]. Human muscular sarcocystosis is so rare in India with a few cases being reported across a wide range of age group [13].…”

Section: Case Reportmentioning

confidence: 99%

Human Sarcocystosis, an Uncommon Etiology for Motor Neuron Disease - A Rare Interesting Case Report

Anuradha¹,

Bharathi²

2012

Int J Med Clin Res

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Abstract-A 45 year old male, non vegetarian by diet, loader by occupation, presented with complaints of progressive muscle wasting and asymmetric weakness of the upper limbs of one month duration, which was followed by similar signs and symptoms in the lower limbs. There was decreased power in the affected limbs. He occasionally had muscle fasciculations. The sensory, bladder, bowel and cognitive functions were well preserved. There was no difficulty in breathing, speaking and swallowing. On the basis of history and neurological examination, a diagnosis of Motor Neuron Disease was made. All the basic investigations were found to be normal. For a definitive diagnosis, muscle biopsy was taken from various sites and to our surprise, it showed many sarcocysts filled with banana shaped bradyzoites of Sarcocystis species. Genus Sarcocystis belongs to the phylum apicomplexa and the class Coccidiea. Muscular sarcocystosis is so rare in India. Sarcocystosis presenting like a Motor Neuron Disease is a diagnostic challenge to the practitioners. The case is presented here for its rarity and to create awareness about the Sarcocystis infection and its presentation like a Motor Neuron Disease.

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An outbreak of acute eosinophilic myositis attributed to human Sarcocystis parasitism.

Cited by 106 publications

References 12 publications

Sarcocystis nesbitti Infection in Human Skeletal Muscle: Possible Transmission from Snakes

Sarcocystis nesbitti Infection in Human Skeletal Muscle: Possible Transmission from Snakes

Muscular Sarcocystosis and Non-Specific Rheumatic Diseases are growing Neglected Coming Challenge

Human Sarcocystosis, an Uncommon Etiology for Motor Neuron Disease - A Rare Interesting Case Report

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