A practical guide for the diagnosis of abdominal angiostrongyliasis caused by the nematode Angiostrongylus costaricensis

Abstract

Abdominal angiostrongyliasis (AA) is a severe parasitic infection caused by the nematode Angiostrongylus costaricensis. This disease is characterized by abdominal pain, a strong inflammatory eosinophilic response in the blood and tissues, and eventually intestinal perforation. Diagnosis of AA is challenging since there are no commercially available serological kits for A. costaricensis, and thus, histopathological analysis remains the gold standard. Herein we provide a decision flowchart for clinicians to improve the diagnosis of AA based on a patient’s clinical manifestations, laboratory findings, macroscopic observations of the gut lesions, as well as characteristic microscopic alterations in biopsies. A brief discussion of the available polymerase chain reaction and in-house serological methods is also presented. The aim of this mini-review is to improve the diagnosis of AA, which should lead to prompt detection of cases and better estimates of the epidemiology and geographical distribution of A. costaricensis. Graphical Abstract

Case report: First documented case of cerebral angiostrongyliasis caused by Angiostrongylus costaricensis in a free-ranging opossum

“…The diagnosis of neuroangiostrongyliasis presents challenges, particularly in wild animals, due to the lack of standardized diagnostic protocols. While serological tests are available for humans, diagnostic tests for veterinary species remain limited or untested ( 4 ). Consequently, it is probable that the identification of this disease will primarily rely on passive surveillance of severe cases and postmortem examinations, as exemplified in our case ( 42 , 43 ).…”

“…Human beings typically serve as unintentional hosts due to the absence of egg deposition or L1 larval release into the intestinal lumen, a process that is characteristic of natural definitive hosts ( 3 ). Instead, the presence of parasite triggers a robust inflammatory response mediated by eosinophils, resulting in a disease known as abdominal angiostrongyliasis ( 4 , 5 ). This condition is characterized by notable pathological features including marked infiltration of eosinophils into the intestinal wall, granulomatous formations, and eosinophilic inflammation of the blood vessels (vasculitis) most prominently affecting the ileocecal region of the intestine ( 1 ).…”

Dispersal and evolution of the invasive snailPomacea canaliculata, an intermediate host ofAngiostrongylus cantonensis: A field study around its initial introduction site in China

“…Vector-borne diseases, which are among the most common classes of emerging and re-emerging infectious diseases, represent a major threat to public health [2]. In particular, this freshwater snail is a vector of the parasitic nematode Angiostrongylus cantonensis (Chen, 1935), which commonly causes eosinophilic meningitis (angiostrongyliasis) in Southeast Asia, Australia, the Caribbean, South America and on Pacific Islands [3,4].…”