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Volume 20, Number 2—February 2014

Anncaliia algerae Microsporidial Myositis

Matthew R. WattsComments to Author , Renee C.F. Chan, Elaine Y.L. Cheong, Susan Brammah, Kate R. Clezy, Chiwai Tong, Deborah Marriott, Cameron E. Webb, Bobby Chacko, Vivienne Tobias, Alexander C. Outhred, Andrew S. Field, Michael V. Prowse, James V. Bertouch, Damien Stark, and Stephen W. Reddel
Author affiliations: Centre for Infectious Diseases and Microbiology Public Health, Westmead, New South Wales, Australia (M.R. Watts, C.E. Webb, A.C. Outhred); Pathology West–Institute for Clinical Pathology and Medical Research Westmead, Westmead (M.R. Watts, C.E. Webb); University of Sydney, Sydney, New South Wales, Australia (M.R. Watts, C.E. Webb, E.Y.L. Cheong, A.C. Outhred, S.W. Reddel); Concord Repatriation General Hospital, Concord West, New South Wales, Australia (R.C.F. Chan, E.Y.L. Cheong, S. Brammah, S.W. Reddel); Prince of Wales Hospital, Randwick, New South Wales, Australia (K.R. Clezy, C. Tong, J.V. Bertouch); St Vincent’s Hospital, Darlinghurst, New South Wales, Australia (D. Marriott, A.S. Field, D. Stark); John Hunter Hospital, Newcastle, New South Wales, Australia (B. Chacko); Liverpool Hospital, Liverpool, New South Wales, Australia (V. Tobias); Port Macquarie Base Hospital, Port Macquarie, New South Wales, Australia (M.V. Prowse)

Main Article

Table 1

Epidemiologic and clinical characteristics of Anncaliia algerae myositis cases-patients*

Characteristic Case-patient A Case-patient B Case-patient 1 (3) Case-patient 2 (5) Case-patient 3 (8)
Age, y/sex 67/M 66/M 57/F 49/M 56/M
Residence Port Macquarie, NSW, Australia Sydney, NSW, Australia PA, USA Woolongong, NSW, Australia Rutherford,
NSW, Australia
Distance from residence to open land, m <100 to golf course <100 to golf course ND <200 to coastal woodland <100 to golf course
Background illness RA RA RA, T2DM Lung Tx, T1DM, CD Lung Tx, kidney Tx
Fever Yes Yes Yes Yes Yes
Fatigue Yes Yes Yes Yes Yes
Weight loss Yes Yes ND Yes Yes
Weakness Yes Yes Yes Yes Yes
Generalized pain Yes Yes Yes Yes Yes
Dysphagia Yes Yes ND Yes Yes
Glossitis Yes Yes ND Yes Yes
Peripheral edema Yes Yes ND Yes Yes
Diarrhea Yes No ND Yes Yes
CNS abnormalities No Delirium Cerebrovascular infarction Delirium, seizures† Delirium

*NSW, New South Wales; PA, Pennsylvania; ND, not described in publication; RA, rheumatoid arthritis; T2DM, type 2 diabetes mellitus. Tx, transplantation; T1DM, type 1 diabetes mellitus; CD, Crohn disease; MTX, methotrexate; CS, corticosteroids; LEF, leflunomide; ETN, ertanercept; IFX: infliximab; AZ, azathioprine; TAC, tacrolimus; MMF, mycophenolate mofetil; CNS, central nervous system.
†Magnetic resonance imaging consistent with cerebral vasculitis; might have been caused by coexistent Aspergillus infection.

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