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Title: AN OUTBREAK OF ACUTE EOSINOPHILIC MYOSITIS ATTRIBUTED TO HUMAN SARCOCYSTIS PARASITISM

Author
item ARNESS, MARK - UNIFORMED SERVICES, MD
item BROWN, JOEL - TRIPLER ARMY FORCES, HI
item Dubey, Jitender
item NEAFIE, RONALD - ARMED FORCES WASH, DC
item GRANDSTROM, DAVID - AM VET MED ASSOC, IL

Submitted to: American Journal of Tropical Medicine and Hygiene
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/6/1999
Publication Date: N/A
Citation: N/A

Interpretive Summary: Parasites of the genus Sarcocystis are single-celled organisms that can cause abortion and weight loss in livestock. Herbivores (sheep, cattle) become infected with Sarcocystis by ingesting the parasite excreted in feces of carnivores and omnivores (dogs, humans). Sarcocystis rarely causes clinical disease in humans. Scientists at the Beltsville Agricultural Research Center and the Uniformed Services University Health Sciences, Bethesda, Maryland report an outbreak of muscle disease associated with Sarcocystis infection in 7 U.S. Army men on a mission in rural Malaysia. The results will be of interest to public health workers, physicians and parasitologists.

Technical Abstract: Seven members of a 15 man military team which had operated in rural Malaysia developed an acute illness consisting of fever, myalgias, bronchospasm fleeting pruritic rashes, transient lymphadenopathy and subcutaneious nodules associated with eosinophilia, elevated erythrocyte sedimentation rate and elevated levels of muscle creatinine kinase. Sarcocysts of an unidentified Sarcocystis species were found in skeletal muscle biopsies of the index case. Albendazole ameliorated symptoms in the index case; however, his symptoms persisted for over five years. Symptoms in five others were mild to moderate and self-limited, and one team member with laboratory abnormalities was asymptomatic. Of eight team members tested for anti-Sarcocystis antibody, six were positive; of four with the eosinophilic myositis syndrome who were tested, all were positive. We attribute this outbreak of eosinophilia-myositis to accidental tissue parasitism by Sarcocystis.