title: An outbreak of acute eosinophilic myositis attributed to human Sarcocystis parasitism.
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.
authors.affiliation: Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA.
authors.forename: M K
authors.initials: MK
authors.lastname: Arness
authors.forename: J D
authors.initials: JD
authors.lastname: Brown
authors.forename: J P
authors.initials: JP
authors.lastname: Dubey
authors.forename: R C
authors.initials: RC
authors.lastname: Neafie
authors.forename: D E
authors.initials: DE
authors.lastname: Granstrom
mesh_terms: D000208:Acute Disease; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000818:Animals; D001219:Aspartate Aminotransferases / Q000097:blood; D001706:Biopsy; D015331:Cohort Studies; D004196:Disease Outbreaks; D004802:Eosinophilia / Q000453:epidemiology / Q000469:parasitology* / Q000473:pathology; D004906:Erythrocyte Count; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008889:Military Personnel; D018482:Muscle, Skeletal / Q000469:parasitology* / Q000473:pathology; D009220:Myositis / Q000453:epidemiology / Q000469:parasitology* / Q000473:pathology; D018512:Parasitemia; D012008:Recurrence; D012423:Rural Health; D012522:Sarcocystis / Q000472:pathogenicity*; D012523:Sarcocystosis / Q000453:epidemiology* / Q000473:pathology; D014481:United States
chemical_list: D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase