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Muscular sarcocystosis: an index case in a native Malaysian
  1. Nurashikin Mohammad,
  2. Alwi Muhd Besari,
  3. Pradeep Kumar Nair,
  4. Wan Syamimee Wan Ghazali
  1. Department of Internal Medicine, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
  1. Correspondence to Dr Wan Syamimee Wan Ghazali, mimeeghazali{at}


A previously healthy 20-year-old man presented with prolonged intermittent low grade fever and cough for 6months. He had bilateral calf pain and lower limb weakness 2days prior to admission. Physical examination revealed multiple enlarged lymph nodes with hepatomegaly. There was bilateral calf tenderness with evidence of proximal myopathy. Full blood picture showed lymphocytosis with reactive lymphocytes and eosinophilia. Creatine kinase and lactate dehydrogenase were markedly elevated. Over 2 weeks of admission, patient was treated symptomatically until the muscle biopsy of right calf revealed eosinophilic myositis with muscular sarcocystosis. He was treated with albendazole and high-dose corticosteroids. Symptoms subsided on reviewed at 2weeks and the dose of corticosteroid was tapered down slowly over a month. Due to poor compliance, he was readmitted 1month later because of relapsed. High-dose corticosteroid was restarted and duration for albendazole was prolonged for 1month. His symptom finally resolved over 2weeks.

  • Infectious Diseases
  • Tropical Medicine (infectious Disease)
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  • Contributors NM, PKN prepared the final draft of manuscript. AMB, WSWG managed the patient. WSWG edited and approved the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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