A parasite is an organism that lives on or in a host organism and derives its nutrients at the expense of its host [1]. Three main classes of parasites can cause disease in humans: protozoa, helminths, and ectoparasites.

Parasitic infections due to protozoa and helminths cause substantial morbidity and mortality worldwide. In 2023, an estimated 263 million malaria cases were found in 83 countries, with 597,000 deaths due to malaria [2].

Soil-transmitted helminth (STH) infections are among the most common infections worldwide, accounting for an estimated 1.5 billion infected people, or 24 % of the global population. The most common species of STHs are Ascaris lumbricoides, Trichuris trichiura, and hookworms (Necator americanus and Ancylostoma duodenale) [3].

Infectious diarrhoea is the third leading cause of death in children below 5 years of age. A significant number of infectious diarrhoeas are caused by intestinal protozoa, the commonest being Cryptosporidium, Giardia, and Entamoeba spp [4].

These infections are more common in tropical and subtropical countries, particularly in communities with limited access to clean water and sanitation. Due to widespread international travel and human migration, these diseases are also being encountered in communities where they are usually not endemic.

Various parasitic diseases may present with rheumatic manifestations such as inflammatory arthritis, myositis, and vasculitis. Parasitic infections are rarely considered in the differential diagnosis of rheumatic complaints. However, in patients with relevant risk factors, it is important to consider these infections in the differential diagnosis of rheumatic syndromes so that they can be appropriately treated.

A study involving stool examination performed in patients having unexplained rheumatic pain attending the rheumatology and rehabilitation outpatient clinic in a university hospital in Egypt showed that 50 of 107 patients with unexplained rheumatic pain had a parasitic infection. Cryptosporidium was the most common (48 %), followed by Cyclospora cayetanensis (32 %), Giardia lamblia (24 %), Blastocystis hominis (20 %), and Entamoeba histolytica (8 %). 16 of the 50 patients (32 %) fulfilled the criteria of parasitic rheumatism, and it was most commonly due to Giardia infection, followed by Cryptosporidium, Cyclospora cayetanensis, Entamoeba histolytica/dispar, and Strongyloides stercoralis [5].

Rheumatic complications of parasitic diseases may also be under-recognized and under-reported in literature. A retrospective matched cohort of individuals from a large administrative claims database in the United States showed that giardiasis was associated with a 51 % increase in claims for arthritis or joint pains [6].

This review focuses on arthritis related to parasitic infections. The possible pathogenesis involved in parasitic arthritis and the various parasitic infections causing arthritis and related musculoskeletal manifestations are reviewed.