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      Abdominal angiostrongyliasis, report of two cases and analysis of published reports from Colombia Translated title: Angiostrongiliasis abdominal, reporte de dos casos y análisis de los casos publicados en Colombia

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          Abstract

          Abstract Abdominal angiostrongyliasis is a parasitic zoonosis, endemic in the American continent. Its etiological agent is Angiostrongylus costaricensis, a nematode whose definitive hosts are rats and other rodents and the intermediate hosts, slugs. Mammals acquire the infection by consuming vegetables contaminated with L3 larvae. The disease shows a heterogeneous clinical spectrum and given its low incidence its diagnosis is a great challenge. In Colombia, the first case was reported in 1979 and until 1998, only five additional cases have been reported. However, in the last two decades, no new cases were reported. Here we discuss two cases of children from Huila and Caquetá departments who developed the disease. Both cases required long in-patient care and multiple surgical interventions. The diagnosis was achieved by histopathological observation of parasitic elements inside the mesenteric arteries. One of the children died while the other fully recovered. We discuss the epidemiology, pathogenic cycle, clinical presentation, diagnosis, and prevention strategies of this disease paying particular attention to our patients’ features and the Colombian context.

          Translated abstract

          Resumen La angiostrongiloidiasis abdominal es una zoonosis parasitaria endémica en el continente americano. Su agente etiológico es el nematodo Angiostrongylus costaricensis, cuyos huéspedes definitivos son los roedores y, los intermediarios, los caracoles y las babosas, por lo que se adquiere al consumir vegetales contaminados con larvas en estadio 3. La presentación clínica es muy variada y, dada su rareza, su diagnóstico es un desafío. En Colombia el primer caso se reportó en 1979 y, desde entonces hasta 1998, se han informado cinco casos más, aunque en las últimas dos décadas no se había reportado ningún caso. Se describen aquí dos casos de angiostrongiloidiasis en niños provenientes de los departamentos de Huila y Caquetá que requirieron una larga hospitalización y múltiples intervenciones quirúrgicas. El diagnóstico se logró al observar en los especímenes quirúrgicos larvas and huevos cuya morfología sugería una infección por nematodos; uno de los pacientes murió y el otro se recuperó satisfactoriamente. Se discuten la epidemiología, la patogenia, la presentación clínica, el diagnóstico y las estrategias de prevención de esta parasitosis, con énfasis en las características particulares de los casos descritos y en el contexto colombiano.

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          Most cited references 40

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          Life history and redescription of Angiostrongylus costaricensis Morera and Céspedes, 1971.

           Blanca Morera (1973)
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            First record of a nematode Metastrongyloidea (Aelurostrongylus abstrusus larvae) in Achatina (Lissachatina) fulica (Mollusca, Achatinidae) in Brazil.

            Achatina (Lissachatina) fulica was introduced in Brazil in the 1980s for commercial purposes ("escargot" farming) and nowadays, mainly by human activity, it is widespread in at least 23 out of 26 Brazilian states and Brasília, including the Amazonian region and natural reserves, where besides a general nuisance for people it is a pest and also a public health concern, since it is one of the natural intermediate host of Angiostrongylus cantonensis, ethiological agent of the meningoencephalitis in Asia. As Brazil is experiencing the explosive phase of the invasion, the Laboratório de Malacologia do Instituto Oswaldo Cruz/Fiocruz has been receiving samples of these molluscs for identification and search for Angiostrongylus cantonensis and Angiostrongylus costaricensis larvae. While examining samples of A. fulica different nematode larvae were obtained, including Aelurostrongylus, whose different species are parasites of felids, dogs, primates, and badger. Morphological and morphometric analyses presented herein indicated the species Aelurostrongylus abstrusus, as well as the occurrence of other nematode larvae (Strongyluris-like) found in the interior of the pallial cavity of A. fulica. This is the first report in Brazil of the development of A. abstrusus infective larvae in A. fulica evidencing the veterinary importance of this mollusc in the transmission of A. abstrusus to domestic cats. Since the spread of A. fulica is pointed out in the literature as one of the main causative spread of the meningoencephalitis caused by A. cantonensis the authors emphasize the need of sanitary vigilance of snails and rats from vulnerable areas for A. cantonensis introduction as the port side areas.
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              Expansion of Achatina fulica in Brazil and potential increased risk for angiostrongyliasis.

              The explosive introduction of the snail Achatina fulica in Brazil illustrates the current concern with global changes favouring dissemination of infectious diseases. The mollusc is an important host for Angiostrongylus cantonensis, which occurs in Asia and the Pacific Islands and is a causative agent for eosinophilic meningoencephalitis. In the Americas there is another metastrongylid worm, An. costaricensis, that causes abdominal disease and may also be transmitted by Ac. fulica. Although both infections may occur in focal outbreaks and with low morbidity, very severe complicated clinical courses pose a challenge for diagnosis and treatment. Data on abdominal angiostrongyliasis are briefly reviewed.
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                Author and article information

                Journal
                bio
                Biomédica
                Biomed.
                Instituto Nacional de Salud (Bogotá, Cundinamarca, Colombia )
                0120-4157
                2590-7379
                June 2020
                : 40
                : 2
                : 233-242
                Affiliations
                Colombia Pasto orgnameHospital Universitario Departamental de Nariño orgdiv1Departamento de Patología
                Bogotá, D.C orgnameFacultad de Medicina, Fundación Universitaria Sanitas Colombia
                Bogotá, D.C orgnameHospital Universitario Fundación Santa Fe de Bogotá orgdiv1Departamento de Patología y Laboratorios Colombia
                Neiva orgnameHospital Universitario Hernando Moncaleano Perdomo orgdiv1Departamento de Patología Colombia
                orgnameUniversidad Nacional de Colombia orgdiv1Departamento de Microbiología Colombia
                Article
                S0120-41572020000200233 S0120-4157(20)04000200233
                10.7705/biomedica.5043

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 10
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