Human infection by Angiostrongylus costaricensis in Venezuela: first report of a confirmed case

Abstract

SUMMARYA proven case of human infection caused by Angiostrongylus costaricensis is reported for the first time in Venezuela. The patient was a 57-year-old female surgically operated because of signs of peritonitis with a palpable mass at the lower right quadrant of the abdomen. WBC count reported 16,600 cells/mm 3 , with 46% eosinophils. The tumoral aspect of ileocolic area and peritoneal lymph nodes prompted the resection of a large area of the terminal ileum, cecum, part of the ascending colon and a small part of the jejunum, where a small lesion was found. The pathology showed thickened areas of the intestinal wall with areas of hemorrhage and a perforation of the cecum. Histology showed intense eosinophil infiltration of the whole intestinal wall, granulomas with giant cells and eosinophils. Some of the granuloma surrounded round or oval eggs with content characterized by a large empty area, cells or embryo in the center, and sometimes nematode larvae. A cross section of an adult nematode worm was observed inside a branch of mesenteric artery. The intestinal affected area, the characteristics of the lesions, the presence of eggs in the submucosa with nematode larvae inside, and the observation of a nematode inside a mesenteric artery, makes sufficient criteria for the diagnosis of an infection by Angiostrongylus costaricensis.

Proteolytic activity in the adult and larval stages of the human roundworm parasite Angiostrongylus costaricensis

“…Humans are incidental hosts and may become infected through the ingestion of infected mollusks or unwashed vegetables (Morera 1973). This parasitic disease has been reported throughout Central and South America (Morera & Cespedes 1971, Incani et al 2007, Palominos et al 2008. In endemic areas, such as the southern region of Brazil, epidemiological and clinical features are used as diagnostic indications of AA (Agostini et al 1983, 1984, Ayala 1987, Graeff-Teixeira et al 1991, Bender et al 2003, Mesen-Ramirez et al 2008, Ben et al 2010, Abrahams-Sandi et al 2011.…”

First record of the semi-slug Omalonyx unguis (d’Orbigny, 1837) (Gastropoda, Succineidae) in the Misiones Province, Argentina

“…Carus, 1835 (Lutz 1921, Pinto and Melo 2013. In South America, these semi-slugs can also serve as potential intermediate hosts of Angiostrongylus vasorum (Baillet, 1866), which has been experimentally proven for O. matheroni (Pontiez & Michaud, 1835), and the parasite A. costaricensis Morera & Céspedes, 1971, whose definitive hosts are canids and rodents respectively, and where humans may act as accidental hosts (Incani et al 2007, Montresor et al 2008, Mozzer et al 2011, Rebello et al 2011.…”

Central nervous system manifestations of Angiostrongylus cantonensis infection

“…Only two species of Angiostrongylus have been confirmed to cause human infection: A. costaricensis , and A. cantonensis (Prociv et al, 2000). A. costaricensis inhabits the mesenteric arteries, causing abdominal angiostrongyliasis with marked eosinophilic infiltration of the viscera, a zoonosis reported from the southern United States to northern Argentina (Incani et al, 2007; Morera and Cespedes, 1970; Rebello et al, 2012; Rodriguez et al, 2014; Thiengo et al, 2013). A. cantonesis is neurotropic, migrating to neural tissue after infection and resulting in three syndromes: eosinophilic meningitis (also known as meningitic angiostrongyliasis), encephalitis, and ocular angiostrongyliasis (Sawanyawisuth and Chotmongkol, 2013).…”