Abdominal Angiostrongyliasis: A Presentation of Eosinophilic Granulomatous Colitis. (August 2018)

• Record Type: Journal Article
• Authors: Walls, Timothy; Cavuoti, Dominick; Channabasappa, Nandini; Yang, Mary; Southern, Paul; Gill, Michelle A.; Park, Jason Y.
• Is Part Of: International journal of surgical pathology. Volume 26:Number 5(2018)
• Page Start: 475
• Page End: 478
• Publication Date: 2018-08
• Subjects: Angiostrongylus costaricensis -- abdominal angiostrongyliasis -- eosinophilic granulomatous colitis -- granuloma -- egg -- inclusion; Pathology, Surgical -- Periodicals; 617.07
• DOI: 10.1177/1066896917749929
• Languages: English
• ISSNs: 1066-8969

Abstract

We present a case of a 4-year-old girl with abdominal angiostrongyliasis who presented with persistent fevers, hepatosplenomegaly, acute abdominal pain, and eosinophilia. Computed tomography scan identified thickening of the ascending colon with a narrowed lumen. Endoscopic evaluation revealed ulcerations and erythema in the ascending colon. The microscopic findings in biopsies included active chronic inflammation with prominent eosinophils and granulomas. A subset of granulomas contained the eggs of Angiostrongylus costaricensis . The definitive method of diagnosing A costaricensis is histology; peripheral blood serology has low specificity and the stool from infected patients does not contain eggs or larvae. Pathologists from endemic regions (Central and South America) are familiar with the typical histologic changes; however, because of increasing global travel, all pathologists should become familiar with A costaricensis, which may mimic common gastrointestinal diseases such as Crohn's disease, appendicitis, and Meckel's diverticulum.