Sarcocystis sp. encephalomyelitis in a cat

Natural Occurring Muscular Sarcocysts in Urban Domestic Cats (Felis catus) Without Sarcocystis-Associated Disease

PURPOSE

Despite of classically acting as definitive hosts of different Sarcocystis species, domestic cats have been pointed out as possible intermediate hosts of S. neurona and S. felis. Nonetheless, details concerning natural sarcocyst development in cats without Sarcocystis-associated disease are scarce. This study aimed to characterize the natural occurrence of muscular sarcocysts in a random group of cats submitted for necropsy.

METHODS

One hundred cats necropsied at a Veterinary Pathology Service were included. Nine different muscular tissues from each cat were sampled for histological analysis and Polymerase Chain Reaction (PCR) using multispecies primers for Sarcocystis neurona, Neospora caninum and Toxoplasma gondii. PCR-positive cases were sequenced for genus and species identification. Epidemiologic data was also analyzed.

RESULTS

Tissue sarcocysts were identified in hematoxylin and eosin-stained slides from five cats, and S. neurona was the only confirmed species. Multifocal sarcocysts affecting two or more muscles were common among positive cats (4/5). Sarcocysts were identified within vastus lateralis (3/5), intercostal (3/5), subscapular (2/5) and diaphragm (2/5) sections. These cysts were always incidental necropsy findings. All sarcocyst-positive cats were from urban areas, among which two were feral and three were pets. Outdoor access was consistently reported. Two cats were positive for retrovirosis, and treatments with potentially immunosuppressive drugs were never stated.

CONCLUSIONS

This study describes the natural occurrence of S. neurona muscular sarcocysts in a random group of cats without Sarcocystis-associated disease. These findings reinforce the participation of feral and pet cats from urban areas as natural intermediate hosts of S. neurona.

Parasitemia due to Sarcocystis neurona-like infection in a clinically ill domestic cat

An 8-year-old, 6-kg, male neutered Domestic Shorthair cat was presented to The Ohio State University Veterinary Medical Center (OSU-VMC) for difficulty breathing. Physical examination and thoracic radiographs indicated pneumonia, a soft-tissue mass in the left caudal lung lobe, and diffuse pleural effusion. The effusion was classified as modified transudate. Rare extracellular elongated (~5-7 μm × 1-2 μm) zoites with a central round to oval-shaped purple to deep purple vesicular nucleus with coarsely stippled chromatin and light blue cytoplasm were seen on a peripheral blood smear. Serum IgG and IgM were positive for Sarcocystis sp. antibodies and negative for Toxoplasma gondii antibodies, suggesting that the infection was acute rather than a recrudescence of prior infection. This organism was most consistent with either Sarcocystis neurona or Sarcocystis dasypi based on DNA sequence analysis of PCR products using COC ssRNA, ITS-1, snSAG2, and JNB25/JD396 primer sets. This is the first report to visualize by light microscopy circulating Sarcocystis sp. merozoites in the peripheral blood of a domestic cat. Therefore, Sarcocystis should be considered as a differential diagnosis in cats with suspected systemic protozoal infection.

No evidence of Sarcocystis calchasi involvement in mammalian meningoencephalitis of unknown origin

Sarcocystis calchasi has recently been identified as the cause of pigeon protozoal encephalitis, PPE, a lethal brain disease in pigeons and parrots. While only avian species have been identified so far to be susceptible to this pathogen as definitive or intermediate hosts, we speculated whether mammals may be susceptible as well, as in Sarcocystis neurona and other related apicomplexan parasites. Specifically, we hypothesized its involvement in mammalian meningoencephalitis of unknown origin, MUO. A total of 143 archived formalin fixed, paraffin embedded brain samples with MUO from dogs, cats, pigs, cattle, sheep, guinea pigs, horses, goats, mice, raccoon, ferret, hamster, mink and maned wolf were examined pathohistologically and by PCR for parasitic stages or DNA, respectively, of Sarcocystis calchasi or other apicomplexan parasites. All samples had non-suppurative, lymphoplasmacytic and/or granulomatous encephalitis or meningoencephalitis typical of MUO with many similarities to PPE in pigeons. However, neither parasitic structures nor DNA of Sarcocystis calchasi or other apicomplexan parasites were detected. It thus appears that, despite histological similarities between mammalian MUO and pigeon PPE and despite seemingly high prevalence of PPE and a persistent threat by Sarcocystis calchasi in pigeons, based on histopathology and PCR there is no evidence for a role of this parasite in MUO in mammals as intermediate or aberrant hosts.

Detection of Sarcocystis spp. infection in bobcats (Lynx rufus)

The protozoan Sarcocystis neurona is an important cause of severe clinical disease of horses (called equine protozoal myeloencephalitis, EPM), marine mammals, companion animals, and several species of wildlife animals in the Americas. The Virginia opossum (Didelphis virginiana) is its definitive host in the USA and other animals act as intermediate or aberrant hosts. Samples of tongue and heart from 35 bobcats hunted for fur and food from Mississippi State, USA in February, 2014 were used for the present study. Muscles were examined for Sarcocystis infection by microscopic examination of either unfixed muscle squash preparations or pepsin digests, by histopathology of fixed samples, and by molecular methods. Sarcocystis-like bradyzoites were found in digests of 14 hearts and 10 tongues of 35 bobcats. In histological sections, sarcocysts were found in 26 of 35 bobcats; all appeared relatively thin-walled similar to S. felis sarcocysts under light microscope at 1000× magnification. S. neurona-like sarcocysts having thickened villar tips were seen in unstained muscle squash of tongue of two bobcats and PCR-DNA sequencing identified them definitively as S. neurona-like parasites. DNA extracted from bradyzoites obtained from tongue and heart muscle digests was analyzed by PCR-DNA sequencing at the ITS1 locus. Results indicated the presence of S. neurona-like parasite in 26 of 35 samples. ITS1 sequences identical to S. dasypi were identified in 3 bobcats, 2 of which were also co-infected with S. neurona-like parasite. The high prevalence of sarcocysts in bobcat tissues suggested an efficient sylvatic cycle of Sarcocystis spp. in the remote regions of Mississippi State with the bobcat as a relevant intermediate host.

An update on Sarcocystis neurona infections in animals and equine protozoal myeloencephalitis (EPM)

Equine protozoal myeloencephalitis (EPM) is a serious disease of horses, and its management continues to be a challenge for veterinarians. The protozoan Sarcocystis neurona is most commonly associated with EPM. S. neurona has emerged as a common cause of mortality in marine mammals, especially sea otters (Enhydra lutris). EPM-like illness has also been recorded in several other mammals, including domestic dogs and cats. This paper updates S. neurona and EPM information from the last 15 years on the advances regarding life cycle, molecular biology, epidemiology, clinical signs, diagnosis, treatment and control.

Severe myositis associated with Sarcocystis spp. infection in 2 dogs

BACKGROUND

Dogs are definitive hosts for numerous species of the intracellular protozoan parasite Sarcocystis. Reports of sarcocysts in muscles of dogs most often represent incidental findings.

HYPOTHESIS/OBJECTIVES

To report the clinicopathologic, ultrastructural, and molecular findings in 2 dogs with myositis associated with Sarcocystis spp. infection, as well as the response to treatment with antiprotozoal drugs.

ANIMALS

Two dogs with severe myositis in association with massive sarcocystosis.

METHODS

Retrospective case review. Affected dogs were identified by a diagnostic laboratory. Attending clinicians were contacted, and the medical records reviewed. Immunostaining and electron microscopy were performed on muscle biopsies. Biopsies also were subjected to 18S rRNA gene PCR.

RESULTS

Both dogs had fever, lymphopenia, thrombocytopenia, and increased serum alanine aminotransferase (ALT) activity when first evaluated. One dog developed hyperbilirubinemia. Subsequently, both dogs had increased serum creatine kinase activity and clinical signs of myositis, with reluctance to move, generalized pain, and muscle wasting. Histopathology of muscle biopsies showed severe inflammatory and necrotizing myopathy with numerous sarcocysts. Ultrastructural studies and 18S rRNA gene sequence results were consistent with infection with a Sarcocystis spp. other than Sarcocystis neurona. Both dogs initially were treated unsuccessfully with clindamycin and anti-inflammatory drugs. One dog died. The other dog subsequently responded to treatment with decoquinate.

CONCLUSIONS AND CLINICAL IMPORTANCE

Sarcocystis spp. infection should be included in the differential diagnosis for dogs that develop fever, thrombocytopenia, increased liver enzyme activities, and clinical and biochemical evidence of myositis. Although additional studies are required, decoquinate holds promise as an effective treatment for the disease.