This week's case features another muscle biopsy - this time from a middle aged man from China with recent visit to Pangkor island. Approximately 10 days after his trip, he presented with high fever, headache, and generalized myalgia. Light microscopic evaluation of H&E-stained sections of muscle showed the following parasites within muscle fibers. What is your diagnosis?
9 comments:
Sarcocystis species
Toxoplasma gondii? Really not sure as I'm no expert on histological stains. Having looked at the DPDx website, the above answer of Sarcocystis seems to look likely too
Thank you James, I follow your lead and did more reading. The more I read, it comes to my mind the realization that the less I know.
I can’t wait to learn some more.
Florida Fan
This was my guess
hmmm...tricky...
These are muscle cysts containing lots of bradyzoites of either Toxoplasma gondii or of a non-human Sarcocystis spp.
In view of the symptoms, I am guessing it'll be Sarcocystis.
Curious for the answer and how to differentiate theses two options!
I think also that is Sarcocytis ..the microscopic type
the course of the disease is more likely to refer to sarcocystosis than Toxoplasmosis in addition to the microscopic shape of the cyst
but still the Toxoplasmosis is another differential diagnosis to be in consideration
My diagnosis is cyst with bradyzoites of Sarcocystis spp. Although to arrive at a species we should use molecular biology techniques, due to the characteristics of the case (muscle tissue, patient traveled to Malaysia) I am in favor of Sarcocystis nesbitii since this species produces cysts in human muscle tissue and outbreaks have been reported in Malaysia
It resembles Chagas but, due to the history, it does not give the diagnosis.
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