In clinical practice, Occam’s Razor is a principle that can usually be applied to diagnose patients with rare neuromuscular conditions. However, a second aetiology needs to be considered if a single cause cannot account for all the symptoms seen in patients. We report the rare case of a patient who developed acute progressive generalised myopathy associated with fever and eosinophilia shortly after returning from a tropical island endemic for muscular sarcocystosis. Subsequently, she was diagnosed with possible coexistent renal cell carcinoma (RCC)-associated antinuclear matrix protein 2 (antiNXP2) myositis with muscular sarcocystosis. She was successfully treated with immunomodulatory treatment, tumour resection and antiparasitic treatment. She made a full and complete clinical recovery.
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