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Although rare, Angiostrongylus costaricensis infection may be a more prevalent etiology of inflammatory bowel disease than ulcerative colitis and Chron's disease in endemic areas in Central and South America. The present study reviewed the occurrence of A. costaricensis in Brazil, its clinical presentation and pathology; and proposed diagnostic criteria and case definitions for abdominal angiostrongyliasis (AA). Southern and southeastern Brazilian regions are the main endemic areas, and AA affects both genders and all age groups. A review of all 23 published reports of 51 Brazilian patients highlighted the following features that were subsequently classified as minor diagnostic criteria: abdominal pain, palpable mass in the right lower abdominal quadrant, history of exposure, ileocecal tumor, and intestinal perforation with wall thickening. Proposed major criteria include right lower quadrant abdominal pain, blood eosinophilia, positive serology (antibody detection), intense eosinophilic infiltration that involves all strata of the intestinal wall, eosinophilic granulomatous reaction, and eosinophilic vasculitis. In addition to the definitions of suspected and possible cases according to increasing strength of evidence of this infection, demonstration of worms/eggs/larvae in tissues or Angiostrongylus DNA in tissues or serum are required for a confirmed diagnosis. The application of the proposed criteria and definitions may improve patient management, epidemiologic surveillance, and identification of new endemic areas.

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Semperula wallacei (Issel, 1874) is a species of terrestrial slug that occurs in southeast China and the Pacific Basin and is the only species of its genus that occurs beyond the Oriental region and to the east of Wallace's line in the Australian region, where it has probably been introduced. In this study, we report for the first time S. wallacei as an intermediate host for Angiostrongylus cantonensis (Chen, 1935) based on histological and molecular analyses of slugs from Tuamasaga, Samoa, deposited at the Medical Malacological Collection (Fiocruz-CMM). DNA was obtained from the deparafinized tissues scraped from specimen slides. Polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP) targeted to the internal transcribed spacer 2 (ITS2) region were carried out using the restriction enzyme Cla I. The RFLP profile observed for our larval specimen of S. wallacei was identical to the profile previously established for A. cantonensis, demonstrating that S. wallacei can be naturally infected with A. cantonensis and is likely to be an intermediate host for this parasitic nematode species in the field. The potential for geographical range expansion of S. wallacei in the Pacific Basin, its small size, and the general role of veronicellids as crop pests and hosts of nematodes, indicate the significance of S. wallacei as an invasive species in the Pacific Basin. Our work also highlights the importance of biological collections for investigating the environmental impact of invasive species on agriculture, public health, and biodiversity conservation.

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BACKGROUND: Angiostrongylus cantonensis (rat lungworm) is the main pathogen responsible for eosinophilic meningitis in humans. One of its intermediate snail hosts, Achatina fulica, was already present in many countries around the world before it appeared in the West Indies in the late 1980s. In the French territories in the Caribbean and northern South America, the first cases of human neuroangiostrongyliasis were reported in Martinique, Guadeloupe and French Guiana in 2002, 2013 and 2017, respectively. In order to better characterize angiostrongyliasis in Guadeloupe, particularly its geographical origin and route of introduction, we undertook molecular characterization of adult worms of Angiostrongylus cantonensis and its intermediate host Achatina fulica. METHODS: Genomic DNA of adult Angiostrongylus cantonensis and Achatina fulica was extracted and amplified by polymerase chain reaction (PCR) targeting the mitochondrial genes cytochrome B and C for A. cantonensis and 16S ribosomal RNA for A. fulica. The PCR products were sequenced and studied by phylogenetic analysis. RESULTS: Cytochrome B and cytochrome C molecular markers indicate a monophyletic lineage of A. cantonensis adult worms in Guadeloupe. Two sequences of A. fulica were identified. CONCLUSIONS: These results confirm the recent introduction of both Angiostrongylus cantonensis and Achatina fulica into Guadeloupe. Achatina fulica in Guadeloupe shares a common origin with those in Barbados and New Caledonia, while Angiostrongylus cantonensis in Guadeloupe shares a common origin with those in Brazil, Hawaii and Japan.

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A identificação precisa de nematódeos de interesse médico-veterinário em amostras de solo ou alimentos é uma ação complexa, devido à grande diversidade de nematódeos no ambiente. O objetivo do estudo foi realizar a caracterização morfológica e morfométrica de diferentes estágios larvários de ancilostomídeos, Strongyloides stercoralis, Strongyloides venezuelensis, Angiostrongylus cantonensis e Angiostrongylus costaricensis, e desenvolver um estudo de similaridade entre espécies do mesmo gênero, a fim de orientar o diagnóstico diferencial com os nematódeos ambientais. As larvas foram fixadas e diversos parâmetros corporais foram mensurados, para os quais foi realizada estatística descritiva e estudo de similaridade. Os resultados médios das larvas padrões foram compatíveis com os descritos para as espécies, com variabilidade em alguns parâmetros. S. stercoralis e S. venezuelensis demonstraram similaridade de 59% para L1 e 79% para L3, com maior diferenciação entre os grupos em relação à extremidade anterior e ao primórdio genital. No pool de larvas de ancilostomídeos, verificou-se uma grande variação nos parâmetros avaliados, especialmente quanto ao comprimento total do corpo. A. cantonensis e A. costaricensis apresentaram 48% de similaridade entre L1 e 76% para L3. Por meio da análise morfométrica e de similaridade verificou-se a possibilidade do aprimoramento do diagnóstico diferencial de nematódeos de origem ambiental. (AU)

Due to the enormous diversity of nematodes in the environment, identifying nematodes of medical and veterinary significance within soil or food samples can be challenging. To facilitate the differential diagnosis with environmental nematodes, this study aimed morphologically and morphometrically characterize various larval stages of hookworms, Strongyloides stercoralis, Strongyloides venezuelensis, Angiostrongylus cantonensi and Angiostrongylus costaricensis. Additionally, a similarity study was conducted among species within the same genus. The larvae were fixated and several body parameters were measured for the analysis, which included a comparison using descriptive statistics. Despite some parameter fluctuation, the average results for standard larvae were consistent with those of the respective species as a whole. The similarity between S. stercoralis and S. venezuelensis was 59% for L1 and 79% for L3, with more pronounced differences observed in the anterior extremity and the genital primordium. The examined parameters exhibited significant variation among the pool of hookworm larvae, particularly concerning the total length of the body. The similarities between A. cantonensis and A. costaricensis larvae ranged from 48% for L1 to 76% for L3. Analyses of morphometric and similarity data provided support for the potential improvement of differentiation between nematodes with environmental origins. This research contributes to enhancing the accuracy of identifying medically and veterinary relevant nematodes present in soil. (AU)

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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.

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This study describes changes in oxidative stress (OS) parameters in mice experimentally infected with Angiostrongylus costaricensis, which causes abdominal angiostrongyliasis. For this, 28 Swiss mice were used, divided into two groups (G1 and G2), with 14 animals each. Of these, eight were infected with ten infective larvae each, by gavage, and six were used as a control group. Mice from G1 and G2 were euthanized at 14 days and 24 days post-infection, respectively. Tissue samples were used for histopathological analysis and blood (serum) samples were taken to assess the levels of proteins, non-protein thiols (NPTs) and nitric oxide (NO), from centrifugation and subsequent collection of aliquots of the supernatant. Among OS parameters, infected mice in both groups had higher NO levels than the control group, due to the presence of: eosinophil infiltrate in the liver and intestine; pancreatitis; and intestinal granuloma. However, the infected mice of both groups showed a reduction in the levels of NPTs, in relation to the control group, due to the presence of: eosinophilic infiltrate in the liver and intestine; and intestinal granuloma. Our results suggest that A. costaricensis infection has important effects on the intestine, liver and pancreas, and the analyses were performed from the tissue of these organs. The mechanisms for these changes are related to the decrease in the body's main antioxidant defences, as demonstrated by the reduction of NPTs, thus contributing to the development of more severe tissue damage. Thus, the objective of the present study was to evaluate the relationship between histopathological lesions and markers for OS.

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La angiostrongiliasis abdominal es una enfermedad parasitaria causada por el género Angiostrongylus costaricensis, un nematodo que infecta a los humanos a través de las secreciones de caracoles o babosas, sus huéspedes definitivos. Costa Rica es el país que se considera más endémico, se ha evidenciado en distintas revisiones que la mayoría de los casos se presentan en niños y personas del sexo masculino. Presentación del caso. Se trata de una mujer de 74 años, que consultó por dolor abdominal agudo, de cuatro días de evolución, acompañado de náuseas, vómitos e hiporexia. Los exámenes de laboratorio reportaron leucocitosis leve y examen general de orina negativo. La ultrasonografía abdominal reportó una masa sólida, heterogénea, mal circunscrita en flanco derecho, esto llevó a la sospecha de una apendicitis aguda. Intervención terapéutica. Se realizó una laparotomía exploradora, con la extirpación de una tumoración de colon perforado que abarcaba desde el ciego hasta el tercio proximal de colon ascendente, además, se realizó una anastomosis de íleo transversa, sin mayor complicación. Evolución clínica. Se manejó con antibióticos y analgésicos, fue dada de alta a los nueve días posteriores al procedimiento, sin complicaciones menores. La biopsia reportó huevos de parásitos consistentes con Angiostrongylus sp

bdominal angiostrongyliasis is a parasitic disease caused by the genus Angiostrongylus costaricensis, a nematode that infects humans through the secretions of snails or slugs, its definitive hosts. Costa Rica is considered the most endemic country, and it has been shown in different reviews that most cases occur in children and males. Case presentation. The patient was a 74-year-old woman who consulted for acute abdominal pain, with four days of evolution, accompanied by nausea, vomiting, and hyporexia. Laboratory tests reported mild leukocytosis and a negative general urine test. Abdominal ultrasonography reported a solid heterogeneous mass, poorly circumscribed in the right lateral abdomen, which led to the suspicion of acute appendicitis. Treatment. An exploratory laparotomy was performed, with the removal of a perforated colon tumor that spanned from the cecum to the proximal third of the ascending colon, in addition, a transverse ileum anastomosis was performed, without further complication. Outcome. She was managed with antibiotics and analgesics and was discharged nine days after the procedure, without complications. The biopsy showed parasite eggs consistent with Angiostrongylus sp

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Abdominal angiostrongyliasis (AA) is a zoonotic disease caused by the nematode Angiostrongylus costaricensis, which is endemic in southern Brazil. Humans become infected by ingesting third-stage (L3) larvae and are considered accidental hosts since neither eggs nor first-stage (L1) larvae are found in feces. The definitive diagnosis can be made by histopathologic examination of surgical specimens or intestinal biopsies. The present study assessed the use of PCR to carry out the molecular detection of AA from serum samples. A total of 62 human serum samples were divided into three groups: (i) 28 serum samples from human patients with presumptive histopathological diagnosis of AA; (ii) 23 serum samples from individuals with unknown serology for AA; (iii) 11 serum samples from patients that suffered from different parasitosis were included. The serum samples were initially tested by in-house indirect ELISA and then by PCR. A total of 14 samples were positive by ELISA, and 6 were positive by PCR. Six samples that were negative by ELISA were positive by PCR. Amplicons were sequenced, and Angiostrongylus DNA was confirmed. We conclude that PCR amplification can be used to confirm Angiostrongylus DNA in serum, which is especially important in cases where antibody levels are too low to be detected. It may also serve as a useful target for survey studies.

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Gurltia paralysans is a nematode first described in 1933 in Chile, causing a syndrome called feline crural parasitic paraplegia. Insects, mollusks, frogs, lizards, and rodents are paratenic hosts of this nematode, and cats probably become infected by ingesting them. This report aims to discuss the main anatomopathological findings of gurltiosis in a cat submitted to necropsy in a laboratory in Ribeirão Preto city, São Paulo state, southeastern Brazil, being the first case reported in this state. The main necroscopic findings were extramedullary reddened areas below the leptomeninges in the cervical and lumbar segments of the spinal cord. The histopathological examination showed marked thickening of the leptomeninges in the lumbar segment of the spinal cord, with marked neovascularization and fibrosis associated with eosinophilic and mononuclear inflammatory infiltration, as well as the presence of intravascular nematodes. The diagnosis of this lesion was chronic segmental meningomyelitis associated with intralesional parasites. Although uncommon, feline gurltiosis is a neglected parasitic disease that should be included as a differential diagnosis of paraparesis in domestic cats.(AU)

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