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 exam- ination, 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 Sarco- cystis 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.
Highlights
Human Muscular Sarcocystosis, a rare zoonotic infection caused by an intracellular coccidian protozoa is seen in tropical and sub tropical countries[1]
Muscular Sarcocystosis is so uncommon where man serves as the intermediate host, who acquires the infection by ingestion of food and water contaminated by the sporocysts that are shed in the feces of the definitive hosts [4]
Muscular Sarcocystosis presenting like a Motor Neuron Disease offered a diagnostic challenge to us which will be described below in the case history
Summary
Human Muscular Sarcocystosis, a rare zoonotic infection caused by an intracellular coccidian protozoa is seen in tropical and sub tropical countries[1]. Human infection is considered rare with less than hundred of published cases, which is very minimal when compared with the global burden of the disease. Muscular Sarcocystosis presenting like a Motor Neuron Disease offered a diagnostic challenge to us which will be described below in the case history. Human Sarcocystosis, an Uncommon Etiology for Motor Neuron Disease - A Rare Interesting Case Report slightly elevated. A differential diagnosis of Motor Neuron Disease, Cervical Spondylosis, Muscular Dystrophy, Cervical Rib, Spinal Radiculitis, Peripheral Neuropathies, and Spinal Cord Tumours were considered. On the basis of history, investigations and neurological examination, a diagnosis of Motor Neuron Disease was made. Muscle biopsy was done from the muscles like biceps, deltoid of the right upper limb, Microscopic examination of the tissue sections of muscle biopsy showed multiple sarcocysts filled with bradyzoites of Sarcocystis species.
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