Hookworm: Difference between revisions

No edit summary
Line 1: Line 1:
==Background==
==Background==
*Necator americanus
*Caused by ''Necator americanus''
*Larvae penetrate through intact skin on contact with feces-contaminated soil
*Larvae penetrate through intact skin on contact with feces-contaminated soil
**Enter the bloodstream, ascend the trachea, descend the esophagus to differentiate into adult worms, and migrate to the upper intestine where they attach to the mucosal wall and feed on host blood
**Enter the bloodstream, ascend the trachea, descend the esophagus to differentiate into adult worms, and migrate to the upper intestine where they attach to the mucosal wall and feed on host blood
Line 8: Line 8:
*Morbidity is related to number of worms harbored in intestines
*Morbidity is related to number of worms harbored in intestines
*Light infections often asymptomatic
*Light infections often asymptomatic
*Heavier infections with variety of manifestations including GI symptoms (abdominal pain, diarrhea, blood in stool, rectal prolapse), malaise, weakness, impaired cognitive / physical development, malnutrition<ref>Wilcox S, Thomas S, Brown D, Nadel E.  “Gastrointestinal Parasite.”  The Journal of Emergency Medicine, 2007; 33(3):277-280</ref></ref>
*Heavier infections with variety of manifestations including GI symptoms (abdominal pain, diarrhea, blood in stool, rectal prolapse), malaise, weakness, impaired cognitive / physical development, malnutrition<ref>Wilcox S, Thomas S, Brown D, Nadel E.  “Gastrointestinal Parasite.”  The Journal of Emergency Medicine, 2007; 33(3):277-280</ref>
*Iron-deficiency [[anemia]]
*Iron-deficiency [[anemia]]
*Hypochromic microcytic anemia
**Hypochromic microcytic anemia
**Adult worms attach to intestinal wall to feed, causing ongoing luminal blood loss
**Adult worms attach to intestinal wall to feed, causing ongoing luminal blood loss


Line 16: Line 16:
{{Helminth Types}}
{{Helminth Types}}


==Workup==
==Diagnosis==


==Management==
==Management==
*Albendazole 400 mg x 1 dose (high efficacy) OR mebendazole 500 mg x 1 dose (low to moderate efficacy)
*Albendazole 400 mg x 1 dose (high efficacy) '''OR''' mebendazole 500 mg x 1 dose (low to moderate efficacy)
*Iron supplements in [[anemia]]
*Iron supplementation for [[anemia]]


==Disposition==
==Disposition==
*Generally may be discharged


==See Also==
==See Also==
Line 30: Line 31:
==External Links==
==External Links==


==Sources==
==References==
<references/>
<references/>
<ref>Becker BM, Cahill JD: Parasitic Infections, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 131:p 1751-1762</ref>
 


[[Category:ID]]
[[Category:ID]]
[[Category:TropMed]]
[[Category:TropMed]]

Revision as of 11:49, 22 August 2015

Background

  • Caused by Necator americanus
  • Larvae penetrate through intact skin on contact with feces-contaminated soil
    • Enter the bloodstream, ascend the trachea, descend the esophagus to differentiate into adult worms, and migrate to the upper intestine where they attach to the mucosal wall and feed on host blood
  • Commonly occurs in warmer climates (tropics, Southeast United States). [1]

Clinical Features

  • Morbidity is related to number of worms harbored in intestines
  • Light infections often asymptomatic
  • Heavier infections with variety of manifestations including GI symptoms (abdominal pain, diarrhea, blood in stool, rectal prolapse), malaise, weakness, impaired cognitive / physical development, malnutrition[2]
  • Iron-deficiency anemia
    • Hypochromic microcytic anemia
    • Adult worms attach to intestinal wall to feed, causing ongoing luminal blood loss

Differential Diagnosis

Helminth infections

Cestodes (Tapeworms)

Trematodes (Flukes)

Nematodes (Roundworms)

Diagnosis

Management

  • Albendazole 400 mg x 1 dose (high efficacy) OR mebendazole 500 mg x 1 dose (low to moderate efficacy)
  • Iron supplementation for anemia

Disposition

  • Generally may be discharged

See Also

External Links

References

  1. Becker BM, Cahill JD: Parasitic Infections, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 131:p 1751-1762
  2. Wilcox S, Thomas S, Brown D, Nadel E. “Gastrointestinal Parasite.” The Journal of Emergency Medicine, 2007; 33(3):277-280