Abstract
An outbreak of fever associated with myalgia and myositis occurred in 2012 among 89 of 92 college students and teachers who visited Pangkor Island, Malaysia. The Sarcocystis nesbitti 18S rRNA gene and sarcocysts were obtained from muscle tissues of 2 students. Our findings indicate emergence of S. nesbitti infections in humans in Malaysia.
Highlights
Sarcocystis spp. infections are emerging parasitic infections among travelers to potentially disease-endemic areas of Southeast Asia
Two leg muscle biopsy specimens were obtained from 2 other patients who reported specific muscle pain and had changes consistent with myositis by magnetic resonance imaging (MRI)
There have been several reports of Sarcocystis spp. infection in Malaysia and of tourists who had traveled to Malaysia [1,2,5,10,11,12,13]
Summary
Sarcocystis spp. infections are emerging parasitic infections among travelers to potentially disease-endemic areas of Southeast Asia. The asexual reproductive stage occurs in the intermediate host and appears to be relatively less species constrained. Sarcocystis spp. infections in humans as the accidental intermediate host have been reported as intramuscular sarcocysts of unknown species [7]. Eighty-nine symptomatic case-patients were identified with onset of fever (94%), myalgia (91%), headache (87%), and cough (40%) ≤26 days upon return. All 8 patients showed changes in muscles of mastication, including superficial temporalis and deep temporalis, and in masseter muscles.
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