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      Angiostrongylus costaricensis, un parásito neotropical cuyo diagnóstico y tratamiento siguen siendo controversiales Translated title: Angiostrongylus costaricensis, a neotropical parasite with a controversial diagnosis and treatment

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          Abstract

          Resumen La angiostrongilosis abdominal es una parasitosis esporádica, que ocurre en países del neotrópico, especialmente en Costa Rica. Es una enfermedad cuyo diagnóstico es infrecuente y su tratamiento controversial. Se presenta un caso de un adulto que muestra un malestar generalizado, dolor abdominal y una intensa eosinofilia que lleva a la detección de una masa en la fosa iliaca inferior derecha. El diagnóstico definitivo se hace mediante la prueba de Morera y el tratamiento incluye el uso de azitromicina y metronidazol, no obstante no se usan antihelmínticos ni se realiza cirugía. El caso descrito pone de manifiesto que tanto el diagnóstico como el tratamiento de esta enfermedad parasitaria continúan siendo inciertos. No se descarta que exista un subregistro importante de esta parasitosis o que los síntomas sean confundidos con otras patologías.

          Translated abstract

          Abstract Abdominal angiostrogyliasis is a sporadic parasitosis that occurs in Neotropical countries, mainly in Costa Rica. It is a disease with an infrequent diagnosis and a controversial treatment. We discuss a case of an adult that presents a severe generalized discomfort, abdominal pain and an intense eosinophilia that leads to the detection of a mass at the right lower quadrant. Definitive diagnosis is achieved by the Morera Test and the treatment includes the use of azythromicin and metronidazole: no antihelmintic drugs or surgery were used. The case shows that both the diagnosis and treatment of this parasitosis are uncertain. An important underreporting of the disease may occur, as well as confusion of the symptoms with other pathologies.

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          Most cited references23

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          Clinical and epidemiological aspects of abdominal angiostrongyliasis in Southern Brazil

          Most of the cases of abdominal angiostrongyliasis in Brazil were reported from the southern States of São Paulo, Paraná, Santa Catarina and Rio Grande do Sul (RS). A study in 27 cases from RS revealed a distinct local epidemiology. Peasants were usually affected, either adults or children, from the mountainous areas in the north of the Suite. There was a seasonal increase in the number of cases, from late spring to autumn, that does not coincide with the rainy season. Besides the most common clinical features of abdominal pain, fever and cosinophilia in the leucogram, painful relapsing episodes were detected in some patients. The abdominal pain could be either localized or diffuse during the rapid evolution to a surgical abdominal condition, with a letality of 7.4%. The use of a serological test and the greater awareness of physicians working in endemic areas is expected to improve the recognition of uncomplicated and benign courses of the disease. This study confirms the known clinical manifestations of abdominal angiostrongyliasis and demonstrates the diversity of its epidemiology.
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            Investigación del huésped definitivo de Angiostrongylus costaricensis Morera y Céspedes 1971

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              Angiostrongylus costaricensis and the intermediate hosts: observations on elimination of L3 in the mucus and inoculation of L1 through the tegument of mollucs

              Human accidental infection with Angiostrongylus costaricensis may result in abdominal disease of varied severity. Slugs from the Veronicellidae family are the main intermediate hosts for this parasitic nematode of rodents. Phyllocaulis variegatus, Phyllocaulis soleiformis and Phyllocaulis boraceiensis were experimentally infected to describe the kinetics of L3 elimination in the mucus secretions of those veronicelid species. A maximum of 2 L3/g/day was found in the mucus, while the number of L3 isolated from the fibromuscular tissues varied from 14 to 448. Productive infection was established by inoculations in the hyponotum or in the body cavity, through the tegument. Intra-cavity injection is a less complex procedure and permits a better control of inocula. A preliminary trial to titrate the infective dosis for P. variegatus indicated that inocula should range between 1000 and 5000 L1. The data also confirmed the importance of P. variegatus as an intermediate host of A. costaricensis.
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                Author and article information

                Journal
                rbt
                Revista de Biología Tropical
                Rev. biol. trop
                Universidad de Costa Rica (San José, San José, Costa Rica )
                0034-7744
                0034-7744
                April 2019
                : 67
                : 2
                : 159-163
                Affiliations
                [1] orgnameUniversidad de Costa Rica Costa Rica gustavo.gutierrez@ 123456ucr.ac.cr
                [2] orgnameCaja Costarricense de Seguro Social rapaezsa@ 123456yahoo.com
                [3] orgnameUniversidad de Costa Rica Costa Rica Maria.ariasechandi@ 123456ucr.ac.cr
                Article
                S0034-77442019000200159 S0034-7744(19)06700200159
                10.15517/rbt.v67i2supl.37222
                35ef2d77-c2c5-46df-ae2a-1f73c1edd631

                This work is licensed under a Creative Commons Attribution 3.0 International License.

                History
                : 17 January 2019
                : 15 November 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 23, Pages: 5
                Product

                SciELO Costa Rica

                Categories
                Artículo

                Angiostrongylus costaricensis,diagnóstico,tratamiento,treatment,diagnostis

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