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HookwormPathophysiology

Hookworm infections are caused by two geohelminths, Ancyclostoma duodenale and Necatur americanus, with differing modes of infection. Clinical manifestations include skin eruptions, respiratory symptoms, abdominal pain, and severe anemia, which can lead to serious complications. Diagnosis is confirmed through stool examination for eggs, and treatment typically involves albendazole along with iron and folate supplementation.

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2 views9 pages

HookwormPathophysiology

Hookworm infections are caused by two geohelminths, Ancyclostoma duodenale and Necatur americanus, with differing modes of infection. Clinical manifestations include skin eruptions, respiratory symptoms, abdominal pain, and severe anemia, which can lead to serious complications. Diagnosis is confirmed through stool examination for eggs, and treatment typically involves albendazole along with iron and folate supplementation.

Uploaded by

rash79259
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Hookworm:

 Pathophysiology,  Clinical  
Manifesta:ons  and  Treatment  
Hookworm:  Pathophysiology  
• 2  geohelminths  associated  with  hookworm;  
Ancyclostoma  duodenale  and  Necatur  
americanus  
• Differences:  Ancyclostoma  can  infect  through  the  
skin  and  by  inges:on,  but  Necatur  can  only  infect  
through  the  skin;  Necatur  larvae  can  grow  in  the  
lungs  but  Ancyclostoma  larvae  cannot  
Hookworm:  Pathophysiology  
• Primary  infec:on  occurs  through  skin  (soles  or  palms)  following  
exposure  to  soil  contaminated  with  human  feces  
• Vesicular  or  pustular  erup:on  may  occur  at  entry  site  
• Ancyclostoma  larvae  migrate  to  the  lungs  via  the  bloodstream,  
where  they  mature  and  travel  uo  the  trachea,  down  the  esophagus,  
and  seJle  in  the  small  intes:ne    
• In  the  small  intes:ne  they  produce  suc:on  impulses  120-­‐200  :mes/
minute,  removing  serum  and  blood  from  the  host  
• Worm  produces  an:coagulant  to  con:nue  serum  and  blood  
availability  
Hookworm:  Pathophysiology  
Hookworm:  Clinical  Manifesta:ons  
• Vesicular  or  pustular  erup:on  at  skin  entry  point,  many  are  
asymptoma:c  
• Necatur  migrates  through  the  lungs;  lungs  may  develop  
alveolar  hemorrhage  and  eosinophilic  and  leukocy:c  
infiltrates  and  pa:ents  may  complain  of  cough,  fever  and  
asthma  
• Small  intes:ne  (distal  duodenum,  jejunum  and  proximal  
ileum)  become  infested  with  worms;  pa:ents  may  
complain  of  abdominal  pain  which  is  relieved  by  ea:ng  
• Pa:ents  may  note  altered  taste,  pica  or  melena  
 
Hookworm:  Clinical  Manifesta:ons  
• Severity  of  disease  related  to  anemia;  
profound  anemia  may  cause  fa:gue,  dyspnea,  
pallor,  palpita:ons,  syncope  and  depression  
• Anemia  may  result  in  conges:ve  heart  failure  
• Generalized  edema  from  hypoproteinemia  
and  CHF  
Hookworm:  Laboratory  Findings  and  Diagnosis  
• Microcy:c  anemia  common  due  to  iron  deficiency  
• Hypoproteinemia  
• During  Necatur  larval  lung  infec:on,  peripheral  
eosinophilia  may  be  seen  
• Diagnosis  made  from  iden:fica:on  of  eggs  in  stool;  
number  of  eggs  may  correlate  with  number  of  
worms  
Hookworm:  Treatment  
• Albendazole  is  the  preferred  op:on  
• Mebendazole  is  also  effec:ve  
• Important  to  provide  iron  and  folate  supplements  
Hookworm:  Case  History  
• 13  yo  boy  presented  with  dyspnea,  hearing  his  pulse  and  
abdominal  pain  
• On  exam  he  is  tachycardic,  pale  and  has  generalized  
edema.    On  abdominal  exam  he  has  epigastric  
tenderness.  
• Hemoglobin  5.3,  MCV  64  
• Stool  exam  reveals  Necatur  eggs  
• Receives  treatment  with  albendazole,  iron  and  folate,  
and  he  recovers  well  

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