SARCOCYSTIS INFECTION: FROM SNAKES TO HUMANS

SARCOCYSTIS INFECTION: FROM SNAKES TO HUMANS

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Numerous Sarcocystis species are known to be involved in complex natural predator-prey life cycles with many different predator animals and with their preferred prey.This protozoan parasite undergoes sexual reproduction in the predator animal (definitive host) to produce sporocysts, which are excreted in the faeces.Upon ingestion by the prey animal (intermediate host), sporozoites emerge, undergo further changes and eventually enter skeletal muscle fibres to form sarcocysts.The life cycle is completed after the predator consumes sarcocyst-containing prey meat.If humans ingest sporocysts from food or water contamination, sarcocysts may develop in skeletal muscles but as opposed to the natural prey, human muscular sarcocystosis is an accidental zoonotic infection.

Since the 1970s, case reports of human muscular sarcocystosis have princess jasmine silhouette been increasingly reported in Malaysia and other countries but not much was known about the species identity.Infections were also commonly thought to be asymptomatic incidental findings in skeletal muscles during routine histopathological examination for other disease conditions.Following outbreaks, mainly among holiday makers to Malaysian islands, it became clear that human muscular sarcocystosis can be associated with significant debilitating morbidity.Patients present with relapsing febrile illness associated with severe myalgia that can last several weeks.Some patients also manifest muscular crewman talc swelling and magnetic resonance imaging may reveal hyperintense lesions in affected muscles.

The muscle biopsies show small sarcocysts containing multiple zoites in skeletal muscle fibres associated with focal myositis.Most patients recover from their symptoms after a few weeks.Molecular analysis of muscle biopsies confirmed infection by S.Nesbitti, a species first described in snakes.Faecal samples from a few Malaysian snakes were found to PCR-positive for S.

nesbitti, suggesting that human infection was probably via snake faeces-contaminated food and/or drinks.This infection is likely to be under-reported since symptoms are rather non-specific.A greater awareness may help with diagnosis, prevention and further research.