Case report of Angiostrongylus costaricensis infection confirmed by histopathological examination.
Lauren de Cássia Ganacini Lima, Laura Rockenbach, Letícia Farina Piva et al.
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Case in brief
A female patient from southern Brazil, with a history of bariatric surgery, presented with right lower quadrant abdominal pain and mild eosinophilia. Initial considerations included infectious colitis and neoplasia. Surgical intervention and histopathological examination confirmed Angiostrongylus costaricensis infection, identified within a mesenteric artery, despite negative PCR results. This case illustrates the importance of histopathology in diagnosis.
What made this case unusual
The case presented with mild eosinophilia and abdominal pain, leading to a differential diagnosis that did not initially include angiostrongyliasis, highlighting the atypical presentation of this infection.
Diagnostic / clinical pearl
Clinicians should consider Angiostrongylus costaricensis in the differential diagnosis of abdominal pain in endemic regions, especially when initial tests yield inconclusive results.
Why it matters
This case emphasizes the need for improved diagnostic methods for angiostrongyliasis, as traditional serological and molecular tests may lack specificity.