RESUMO
We present the first, probably autocton, case of abdominal angiostrongyliasis in Rio de Janeiro State. The patient presented initially with fever of unknown origin and severe eosinophilia developing acute abdomen due to small bowel perfuration, peritonitis, hepatic necrosis and sepsis. At the laparotomy a segment of small bowel was ressected and a liver biopsy was performed. Histopatology revealed the presence of an intra-arterial nematode, eosinophilic arteritis and granuloma. It is discussed the clinicopathological aspects of this rare and potentially severe disease that has not an established drug treatment since oral anti-helmintics are contra-indicated. The authors emphasize the importance of avoiding indiscriminate use of oral anti-helmintic drugs based only in blood eosinophilia.