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      Angiostrongylus costaricensis infection in Martinique, Lesser Antilles, from 2000 to 2017 Translated title: Infections par Angiostrongylus costaricensis à la Martinique, Antilles, de 2000 à 2017

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          Abstract

          Human abdominal angiostrongyliasis (HAA) is a parasitic disease caused by the accidental ingestion of the nematode Angiostrongylus costaricensis in its larval form. Human infection can lead to severe ischemic and inflammatory intestinal lesions, sometimes complicated by life-threatening ileal perforations. Only one case had been reported in Martinique, an Island in the French Antilles, in 1988. We retrospectively reviewed the medical charts of patients diagnosed with abdominal angiostrongyliasis at the University Hospital of Martinique between 2000 and 2017. The objectives of this study were to evaluate the incidence and perform a descriptive analysis of the clinical, biological, radiological, and histopathological features of HAA in Martinique. Two confirmed cases and two probable cases were identified in patients aged from 1 to 21 years during the 18-year period, with an estimated incidence of 0.2 cases per year (0.003 case/year/100.000 inhabitants (IC95% = 0.00–0.05)). All patients presented with abdominal pain associated with high blood eosinophilia (median: 7.24 G/L [min 4.25; max 52.28 G/L]). Two developed ileal perforation and were managed by surgery, with diagnostic confirmation based on histopathological findings on surgical specimens. The other two cases were probable, with serum specimens reactive to Angiostrongylus sp. antigen in the absence of surgery. All cases improved without sequelae. The description of this case series highlights the need to increase awareness of this life-threatening disease in the medical community and to facilitate access to specific diagnostic tools in Martinique. Environmental and epidemiological studies are needed to broaden our knowledge of the burden of this disease.

          Translated abstract

          L'angiostrongylose abdominale humaine (AAH) est une maladie parasitaire causée par l'ingestion accidentelle du nématode Angiostrongylus costaricensis sous sa forme larvaire. L'infection humaine peut conduire à des lésions intestinales ischémiques et inflammatoires sévères, parfois compliquées par des perforations iléales menaçant le pronostic vital. Un seul cas avait été signalé en Martinique, une île des Antilles françaises, en 1988. Nous avons revu rétrospectivement les dossiers médicaux des patients ayant reçu un diagnostic d'angiostrongylose abdominale au CHU de la Martinique entre 2000 et 2017. Les objectifs de cette étude étaient d'évaluer l'incidence et effectuer une analyse descriptive des caractéristiques cliniques, biologiques, radiologiques et histopathologiques de l'AAH en Martinique. Deux cas confirmés et deux cas probables ont été identifiés chez des patients âgés de 1 à 21 ans au cours de la période de 18 ans, avec une incidence estimée à 0,2 cas par an (0,003 cas / an / 100 000 habitants (IC95% = 0,00 − 0,05)). Tous les patients présentaient une douleur abdominale associée à une éosinophilie sanguine élevée (médiane: 7,24 G/L [min 4,25; max 52,28 G / L]). Deux ont développé une perforation iléale et ont été traités par chirurgie, avec une confirmation diagnostique basée sur les résultats histopathologiques sur des échantillons chirurgicaux. Les deux autres cas étaient probables, avec des échantillons sériques réagissant aux antigènes d' Angiostrongylus sp. en l'absence de chirurgie. Tous les cas se sont améliorés sans séquelles. La description de cette série de cas souligne la nécessité de sensibiliser davantage la communauté médicale à cette maladie potentiellement mortelle et de faciliter l'accès à des outils diagnostiques spécifiques en Martinique. Des études environnementales et épidémiologiques sont nécessaires pour élargir nos connaissances sur cette parasitose.

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          Most cited references 87

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

           Blanca Morera (1973)
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            Species of Angiostrongylus (Nematoda: Metastrongyloidea) in wildlife: A review

            Highlights • Twenty-one species of Angiostrongylus are recognised from wildlife around the world. • Details of hosts, life cycles, pathogenesis, geographical range are known for nine. • Six species are spreading into new regions locally or globally. • Two species, A. cantonensis and A. costaricensis, are zoonotic. • A. mackerrasae, A. malaysiensis and A. siamensis are potentially zoonotic. • Debilitating disease occurs in avian and mammalian wildlife and humans in Australia.
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              On the diversity of mollusc intermediate hosts of Angiostrongylus costaricensis Morera & Cespedes, 1971 in southern Brazil

              Veronicellid slugs are considered the most important intermediate hosts of Angiostrongylus costaricensis, an intra-arterial nematode of rodents. Studies undertaken in three localities in southern Brazil led to identification of molluscs other than veronicellid slugs as hosts of A. costaricensis: Limax maximus, Limax flavus and Bradybaena similaris. These data indicate a low host specificity of larval stages of A. costaricensis, as it has been reported to other congeneric species.
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                Author and article information

                Journal
                Parasite
                Parasite
                parasite
                Parasite
                EDP Sciences
                1252-607X
                1776-1042
                2018
                10 April 2018
                : 25
                : ( publisher-idID: parasite/2018/01 )
                Affiliations
                [1 ] Laboratoire de Parasitologie-Mycologie-Sérologies Bactériennes et Parasitaires, CHU de la Martinique, 97200 Fort-de-France France
                [2 ] Laboratoire de Parasitologie-Mycologie, CHU Grenoble Alpes, 38700 Grenoble France
                [3 ] Institute for Advanced Biosciences (IAB), INSERM U1209 − CNRS UMR5309, Université Grenoble Alpes, 38700 Grenoble France
                [4 ] Service de Maladies Infectieuses et Tropicales et Médecine Polyvalente, CHU de la Martinique, 97200 Fort-de-France France
                [5 ] EA3593, Ecosystèmes Amazoniens et Pathologie Tropicale, Université de la Guyane, 97306 Cayenne France
                [6 ] Service de Pédiatrie, Maison de la Femme de la Mère et de l'Enfant, 97200 Fort-de-France France
                [7 ] Laboratoire de Biologie Médicale, Centre Hospitalier de Basse-Terre, 97109 Basse-Terre, Guadeloupe France
                [8 ] Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier Andrée Rosemon, 97306 Cayenne France
                [9 ] CIC Antilles-Guyane, INSERM 1424, Centre Hospitalier Andrée Rosemon, 97306 Cayenne France
                [10 ] Université des Antilles, EA4537, 97200 Fort-de-France France
                Author notes
                [a]

                These authors contributed equally to this work.

                Article
                parasite180020 10.1051/parasite/2018022
                10.1051/parasite/2018022
                5892178
                29633710
                © C. Dard et al., published by EDP Sciences, 2018

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 4, Tables: 3, Equations: 0, References: 71, Pages: 13
                Categories
                Research Article

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