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Sarcosporidiosis Clinical Presentation

  • Author: Edward Charbek, MD; Chief Editor: Mark R Wallace, MD, FACP, FIDSA  more...
 
Updated: Oct 07, 2015
 

History

Since most cases of sarcosporidiosis have been documented in Southeast Asia, a travel history and detailed history of recent dietary practices may be of benefit.[10]

Symptoms caused by the myositic form of sarcosporidiosis occasionally include painful muscle swellings accompanied by erythema, muscle tenderness, generalized muscle weakness, and fever. Cardiac involvement is almost always asymptomatic, but sarcosporidiosis has been known to cause second-degree atrioventricular block in sheep.[11]

Within a day after ingestion of contaminated beef or pork, individuals who develop the enteritis form of sarcosporidiosis may experience diaphoresis, chills, fever, vomiting, and diarrhea.[12]

Common Sarcocystis species found in raw kibbe (Middle Eastern dish of lamb and seasonings, eaten cooked or raw) include Sarcocystis hominis, Sarcocystis hirsuta, and Sarcocystis cruzi.[13]

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Physical

In muscle involvement, painful nodular swelling (1-3 cm in diameter) with erythema and tenderness usually occurs following disintegration of the cysts. On occasion, these nodular lesions are accompanied by fever, diffuse myalgias, weakness, and bronchospasm.[14] This form of infection is extremely rare and has been described in fewer than 100 human cases. This may support the hypothesis that humans are accidental intermediate hosts.[1]

Persons who ingest the oocyst may develop clinically apparent dehydration after acute diarrhea and diffuse abdominal tenderness.

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Causes

Humans become infected with intestinal sarcocystosis after eating infected meat. People who ingest undercooked beef or pork are at increased risk of infection. Individuals who practice poor hand hygiene, thus exposing themselves to fecal-oral transmission, are also at an increased risk of acquiring intestinal sarcocystosis.

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Contributor Information and Disclosures
Author

Edward Charbek, MD Fellow in Pulmonary/Critical Care Medicine, St Louis University Hospital

Disclosure: Nothing to disclose.

Coauthor(s)

Nirav Patel, MD Assistant Professor of Internal Medicine, Division of Infectious Diseases, Allergy and Immunology and Division of Pulmonary, Critical Care, and Sleep Medicine, St Louis University School of Medicine; Interim Chief Medical Officer, Director of Antibiotic Stewardship, Infection Control Officer, St Louis University Hospital

Nirav Patel, MD is a member of the following medical societies: American Medical Association, Infectious Diseases Society of America, Missouri State Medical Association, Society for Healthcare Epidemiology of America, Society of Critical Care Medicine, Infectious Diseases Society of St Louis, St Louis Metropolitan Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Joseph F John, Jr, MD, FACP, FIDSA, FSHEA Clinical Professor of Medicine, Molecular Genetics and Microbiology, Medical University of South Carolina College of Medicine; Associate Chief of Staff for Education, Ralph H Johnson Veterans Affairs Medical Center

Joseph F John, Jr, MD, FACP, FIDSA, FSHEA is a member of the following medical societies: Charleston County Medical Association, Infectious Diseases Society of America, South Carolina Infectious Diseases Society

Disclosure: Nothing to disclose.

Chief Editor

Mark R Wallace, MD, FACP, FIDSA Clinical Professor of Medicine, Florida State University College of Medicine; Clinical Professor of Medicine, University of Central Florida College of Medicine

Mark R Wallace, MD, FACP, FIDSA is a member of the following medical societies: American College of Physicians, American Medical Association, American Society for Microbiology, Infectious Diseases Society of America, International AIDS Society, Florida Infectious Diseases Society

Disclosure: Nothing to disclose.

Additional Contributors

Raphael J Kiel, MD Associate Professor of Medicine, Wayne State University School of Medicine; Associate Professor of Medicine, Oakland University William Beaumont School of Medicine; Consulting Staff, Infectious Diseases Division, William Beaumont Hospital; Consulting Staff, Infectious Diseases Division Providence Hospital

Raphael J Kiel, MD is a member of the following medical societies: American College of Physicians-American Society of Internal Medicine, American Geriatrics Society

Disclosure: Nothing to disclose.

Nicholas R Ondrasik, DO Resident Physician, Department of Internal Medicine, Tripler Army Medical Center

Nicholas R Ondrasik, DO is a member of the following medical societies: American Medical Association, American Osteopathic Association, Christian Medical and Dental Associations, Association of Military Osteopathic Physicians and Surgeons

Disclosure: Nothing to disclose.

Gunther Hsue, MD Consulting Staff, Department of Infectious Diseases, Chief, Multi-Specialty Clinic, Tripler Army Medical Center

Gunther Hsue, MD is a member of the following medical societies: American College of Physicians, Infectious Diseases Society of America, Armed Forces Infectious Diseases Society

Disclosure: Nothing to disclose.

Acknowledgements

Kenneth C Earhart, MD Deputy Head, Disease Surveillance Program, United States Naval Medical Research Unit #3

Kenneth C Earhart, MD is a member of the following medical societies: American College of Physicians, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, and Undersea and Hyperbaric Medical Society

Disclosure: Nothing to disclose.

References
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  12. Piekarski G, Heydorn AO, Aryeetey ME, et al. [Clinical, parasitological and serological investigations in sarcosporidiosis (sarcocystis suihominis) of man (author's transl)]. Immun Infekt. 1978 Aug. 6(4):153-9. [Medline].

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