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Hookworm Infestation 

Title               

Ñ    Hookworm Infestation  (ancylostomiasis)

Definition

Ñ    Infestation by hookworms

Aetiology

Ñ    Ancylostoma duodenale

Ñ    Necator americanus

Pathogenesis

Life Cycle

Ñ    Filariform larvae penetrate the skin

Ñ    Travel to the lung capillaries, penetrate into the alveoli, migrate up the bronchial tree, coughed and swallowed

Ñ    Enter the small intestine, moult and become adults:

Anywhere between the stomach and the colon

Ñ    Adults mate and produce eggs which are passed in the stools and hatch in 24 hours

Ñ    Initially rhabditiform larva then filariform

Histology

Ñ    No change

Ñ    Petechial haemorrhages, erosions, congestion and oedema

Ñ    Changes similar to tropical sprue

Clinical Features

Incubation period

Ñ    1-2 weeks

History

IS

Ñ    Irritating papular or vesicular rash (ground itch) at site of entry

HS

Ñ    Fatigue:

Anaemia

Ñ    Breathlessness:

Anaemia

RS

Ñ    Cough, wheeze:

Pulmonary stage

GIT

Ñ    Abdominal discomfort

Ñ    Bloody diarrhoea:

Acute stage, not common

Social History

Ñ    Visit to or residence in endemic area

Examination

IS

Ñ    Rash

Ñ    Generalised oedema:

·          Hypoalbuminaemia:

Protein losing enteropathy

Ñ    Koilonychia

CVS

Ñ    Heart failure:

Severe infestation

GIT

Ñ    Ascites:

Severe hypoalbuminaemia

CNS

Ñ    Retinal haemorrhages:

Severe anaemia

Investigations

Fluids

Blood

Haematology

Ñ    Hypochromic microcytic anaemia

Ñ    Eosinophilia:

Pulmonary phase

Stools

Microbiology

Ñ    Ova

Management

Cure

Drugs

Ñ    Albendazole

Ñ    Levamisole

Ñ    Pyrantel

Ñ    Mebendazole

Prevention

Drugs

Ñ    Treat cases

Lifestyle Adjustments

Footwear

Ñ    Encourage use of footwear in endemic areas

Residence

Ñ    Correct disposal of faeces

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