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  1. #1
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  12. #12
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    The American Journal of Tropical Medicine & Hygiene: Vol. 61, No. 4, pp. 548553.

    AN OUTBREAK OF ACUTE EOSINOPHILIC MYOSITIS ATTRIBUTED TO HUMAN SARCOCYSTIS PARASITISM
    MARK K. ARNESS,a JOEL D. BROWN,a J. P. DUBEY,a RONALD C. NEAFIE,a and DAVID E. GRANSTROMa

    aDepartment of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland; Tripler Army Medical Center, University of Hawaii John A. Burns School of Medicine, and the Queens Medical Center, Honolulu, Hawaii; Parasite Biology and Epidemiology Laboratory, U.S. Department of Agriculture Research Center, Agricultural Research Service, Livestock and Poultry Sciences Institute and Parasite Biology and Epidemiology Laboratory, Beltsville, Maryland; Parasitic Diseases Pathology Branch, Armed Forces Institute of Pathology, Washington, District of Columbia; American Veterinary Medical Association, Chicago, Illinois.


    ABSTRACT

    Seven members of a 15-man U.S. military team that had operated in rural Malaysia developed an acute illness consisting of fever, myalgias, bronchospasm, fleeting pruritic rashes, transient lymphadenopathy, and subcutaneous 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 more than 5 years. Symptoms in 5 other men were mild to moderate and self-limited, and 1 team member with laboratory abnormalities was asymptomatic. Of 8 team members tested for antibody to Sarcocystis, 6 were positive; of 4 with the eosinophilic myositis syndrome who were tested, all were positive. We attribute this outbreak of eosinophilic myositis to accidental tissue parasitism by Sarcocystis.

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