Introduction
-Hookworm disease is caused by the Infection with the hookworms Ancylostoma duodenale and Necator americanus
-Adult hookworm possess two pairs of teeth in the buccal capsule
-Male hookworm has a characteristic copulatory bursa
-Infectious larvae present in soil penetrate the skin, enter bloodstream, reach the lungs, invade the alveoli, ascend the airways, are swallowed, reach the intestines, mature into adult worms, attach to the mucosa, and suck blood
Symptoms & Signs
Most infected persons are asymptomatic
Skin: Initial skin infection by the larval penetration may cause a pruritic maculopapular rash (ground itch) and serpiginous tracks of subcutaneous migration (cutaneous larva migrans)
Lungs: Pulmonary symptoms during larval migration through the lungs include fever, cough and wheezing
Gastrointestinal: Abdominal pain, anorexia, nausea, vomiting, diarrhea, ascites
Hematological: Hypochromic microcytic anemia, eosinophilia, hypoalbuminemia
Diagnosis
Diagnosis is based on the identification of characteristic eggs in feces
Adult worms: Ancylostoma duodenale possesses four sharp tooth-like structures, whereas N americanus has dorsal and ventral cutting plates; the males have a unique fan-shaped copulatory bursa
Labs: Microcytic anemia, occult blood in the stool, hypoalbuminemia, eosinophilia
Treatment
Effective agents: Albendazole, Mebendazole, Pyrantel pamoate