Vázquez J J, Boils P L, Sola J J, Carbonell F, de Juan Burgueño M, Giner V, Berenguer-Lapuerta J
Department of Pathology, University Clinic and School of Medicine, University of Navarra, Pamplona, Spain.
Gastroenterology. 1993 Nov;105(5):1544-9. doi: 10.1016/0016-5085(93)90163-7.
Angiostrongylus costaricensis causes a clinicopathologic disease first observed in Costa Rica, mainly in children characterized by highly symptomatic eosinophilic gastroenteritis involving the terminal ileum, cecum, appendix, and ascending colon. A case of angiostrongyliasis in an adult Spaniard infected during a brief stay in Nicaragua is reported. We examined the macro-microscopic features of a right ileocolic resection of a 52-year-old patient. In the surgical specimen, multiple confluent ulcers, some perforated, were observed particularly in the terminal ileum. The intestinal wall was thickened, and the arterial branches presented necrotizing arteritis with thrombosis and a heavy infiltrate of eosinophils around the vessels. In addition, some granulomas were observed. Adult male and female forms of A. costaricensis were found in the lumen of many arterial branches and in the tissue of the omentum, surrounded by dense eosinophilic infiltrate. A. costaricensis causes an intense eosinophilic, necrotizing arteritis associated with thrombosis leading to severe ischemic lesions. This is the first case to be diagnosed in Europe. Incubation time was able to be established within a period of at least 14 days.
哥斯达黎加管圆线虫可引发一种临床病理疾病，该病最早在哥斯达黎加被观察到，主要发生在儿童中，其特征为累及回肠末端、盲肠、阑尾和升结肠的高度症状性嗜酸性粒细胞性胃肠炎。本文报道了一名成年西班牙人在短暂停留尼加拉瓜期间感染管圆线虫病的病例。我们检查了一名52岁患者右半结肠切除术标本的大体和微观特征。在手术标本中，尤其是在回肠末端观察到多个融合性溃疡，有些已穿孔。肠壁增厚，动脉分支呈现坏死性动脉炎伴血栓形成，血管周围有大量嗜酸性粒细胞浸润。此外，还观察到一些肉芽肿。在许多动脉分支管腔和大网膜组织中发现了成年雌雄形态的哥斯达黎加管圆线虫，周围有密集的嗜酸性粒细胞浸润。哥斯达黎加管圆线虫可引发强烈的嗜酸性粒细胞性坏死性动脉炎并伴有血栓形成，导致严重的缺血性病变。这是欧洲首例确诊病例。潜伏期至少在14天内得以确定。
