Human Infections with Sarcocystis Species

Abstract

SUMMARY Recurrent outbreaks of muscular sarcocystosis among tourists visiting islands in Malaysia have focused international attention on sarcocystosis, a disease once considered rare in humans. Sarcocystis species require two hosts, definitive and intermediate, to complete their life cycle. Humans can serve as definitive hosts, with intestinal sarcocystosis for two species acquired from eating undercooked meat: Sarcocystis hominis , from beef, and Sarcocystis suihominis , from pork. Symptoms such as nausea, stomachache, and diarrhea vary widely depending on the number of cysts ingested but appear more severe with pork than with beef. Humans serve as intermediate hosts for Sarcocystis nesbitti , a species with a reptilian definitive host, and possibly other unidentified species, acquired by ingesting sporocysts from feces-contaminated food or water and the environment; infections have an early phase of development in vascular endothelium, with illness that is difficult to diagnose; clinical signs include fever, headache, and myalgia. Subsequent development of intramuscular cysts is characterized by myositis. Presumptive diagnosis based on travel history to tropical regions, elevated serum enzyme levels, and eosinophilia is confirmed by finding sarcocysts in muscle biopsy specimens. There is no vaccine or confirmed effective antiparasitic drug for muscular sarcocystosis, but anti-inflammatory drugs may reduce symptoms. Prevention strategies are also discussed.

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

“…Patients investigated in the present study had actual musculoskeletal complaints from months to several years, especially myalgia, but they had no intestinal complaints (Tappe et al, 2013;Fayer et al, 2015). Sarcocystosis should be considered in the differential diagnosis when a patient developed fever and myalgia especially after travelling to endemic area (Slesak et al, 2015).…”

“…An environmental survey to detect the source of muscular sarcocystosis infection, animal reservoirs and effective anti-parasitic drug is needed for prevention strategies especially in endemic areas Fayer et al, 2015). It remains to be determined whether environmental factors, such as climate change or increasing reptile populations (i.e.…”

“…Diagnoses are confirmed by finding Sarcocystis cyst in muscle biopsy (Tappe et al, 2013;Fayer et al, 2015).…”

“…Faeces containing sporocysts lead to muscular sarcocystosis (no intestinal phase). It is found in skeletal, cardiac, smooth muscles and neural tissue (Abdul-Rahman et al, 2002;Fayer, 2004;Jehle et al, 2009;Prakas and Butkausas, 2012;Fayer et al, 2015). The second form is intestinal sarcocystosis which results from eating raw or undercooked meat containing mature Sarcocystis cyst.…”

“…It is caused by Sarcocystis which is an intracellular apicomplexan/coccidian parasite, with more than 120 recognized species. Recurrent outbreaks of muscular sarcocystosis among tourists visiting endemic areas focused the international attention on this disease Fayer et al, 2015). Human sarcocystosis has two forms.…”