HistoryThis section has been translated automatically.
DefinitionThis section has been translated automatically.
Ancylostomiasis (ancylostomatidosis) or hookworm disease is a chronic intestinal infection with the hookworm species Ancylostoma duodenale, Necator americanus and Ancylostoma ceylanicum.
Ancylostomatidae (from ankylos = crooked) are a family ofnematodes. The parasites are 0.7-1.8cm long and filamentous. Their front end is bent hook-shaped . Characteristic for these worms is a mouth capsule with tooth-like structures
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PathogenThis section has been translated automatically.
Ancylostoma duodenale, old world hookworm (the name "duodenal" is absolutely misleading as the live adult worms do not live in the duodenum but in the jejunum and ileum).
Necator americanus and Ancylostoma ceylanicum are the new world hookworm species.
Occurrence/EpidemiologyThis section has been translated automatically.
About 50 million patients are symptomatically ill worldwide; 400-900 million people are asymptomatic hosts. Ancylostoma used to be a disease of miners and workers in tunnel construction and the like. This is no longer the case. Today, its distribution is restricted to tropical and subtropical regions. In endemic areas (Africa, Southern Europe, Central and South America, Southern USA) a considerable part of the population is infected. Worm infection mainly occurs during work in rice fields and when walking barefoot on contaminated soil.
EtiopathogenesisThis section has been translated automatically.
The infection is predominantly percutaneous. The invasion of the hookworm larvae takes place on uncovered skin (mostly soles/back of the feet). Subsequent larval migration by the blood or lymphatic route into the pulmonary vessels (heart-lung passage). In the lungs they cause a volatile inflammation which clinically appears as eosinophilic Löffler infiltrate.
The lungs are exited via alveoli, bronchi, trachea.
The larvae enter the pharynx, are swallowed and ultimately settle in the jejunum and ileum. There development to sexual maturity.
Adult hookworms attach to the mucosa and suck blood. The presence of the worms causes abdominal pain, flatulence, loss of appetite with weight loss, and permanent iron deficiency anemia. The female worms release about 20,000 eggs daily, which are passed into the environment with the faeces.
ManifestationThis section has been translated automatically.
Common among agricultural workers in rice fields, tunnel and brick workers, coffee plantation workers.
Clinical featuresThis section has been translated automatically.
Later, depending on the migration routes of the larvae, there may be pulmonary symptoms (eosinophilia, radiographic cloud-like pulmonary infiltrates - Löffler infiltrate), anemia, heart failure, digestive disorders, malnutrition. If the larvae are not swallowed, they settle in the throat and cause hoarseness, nausea, salivation and cough.
LaboratoryThis section has been translated automatically.
Eosinophilia, iron-deficiency anemia.
DiagnosisThis section has been translated automatically.
Detection of worm eggs in fresh stool!
External therapyThis section has been translated automatically.
Tiabendazole: Success has been described with a 10% aqueous tiabendazole solution (e.g. Mintezol) applied externally 4-5 times/day for 1 week. 2% Tiabendazole can also be applied externally in 90% DMSO(Tiabendazole 2% in DMSO solution application several times a day) or 10% in a glucocorticoid cream. On the sole of the foot, a 10% Tiabendazole ointment (if necessary with glucocorticoid additive R252 ) under occlusion (2 times 4 hours a day) is recommended, therapy duration 5-7 days.
The external icing methods (liquid nitrogen in spray or closed contact method, see also cryosurgery) have more side effects and are less effective than tiabendazole.
Internal therapyThis section has been translated automatically.
Progression/forecastThis section has been translated automatically.
Note(s)This section has been translated automatically.
Infections with hookworm species, for which humans are the false host, lead to a localized clinical picture of the skin, the
LiteratureThis section has been translated automatically.
- Albonico M et al. (2003) Efficacy of mebendazole and levamisole alone or in combination against intestinal nematode infections after repeated targeted mebendazole treatment in Zanzibar. Bull World Health Organ 81: 343-352
- Brenner MA et al (2003) Cutaneous larva migrans: the creeping eruption. Cutis 72: 111-115
- Caumes E et al (1992) Efficacy of ivermectin in the therapy of cutaneous larva migrans. Arch Dermatol 128: 83-87
Chu S et al (2013) Hookworm dermatitis due to Uncinaria stenocephala in a dog from Saskatchewan. Can Vet J 54:743-747.
- Cooper PJ et al (2003) Reduced risk of atopy among school-age children infected with geohelminth parasites in a rural area of the tropics. J Allergy Clin Immunol 111: 995-1000
- Dubini A (1843) Nuovo verme intestinal umano (Ancylostoma duodenale) constituente un sesto genere die nematoidea propri dell' uomo. Ann Universali Med 106: 5-13
- Griesinger W (1854) Clinical and anatomical observations on the diseases of Egypt. Arch Physiol Heilkd 13: 528-575.
- Kim SC et al (2003) Pruritic skin eruption on the left foot of a 36-year-old woman. Clin Infect Dis 37: 406, 448-449
- Ponnighaus JM et al (2000) Pruritus of dark skin in hookworm infection. Dermatologist 51: 953-955
Incoming links (11)Ancylostoma ceylanicum; Ancylostomatidae; Chlorosis, egyptian; Hookworm disease; Larva migrans; Miner's worm disease; Nematodes; Tiabendazole 10%-betamethasone 0.1% cream (o/w); Tiabendazole 2% in dmso solution; Tunnel anaemia; ... Show all
Outgoing links (15)Albendazole; Ancylostoma ceylanicum; Ancylostomatidae; Cryosurgery; Eczema (overview); Ivermectin; Larva migrans; Löffler syndrome; Löffler syndrome; Mebendazole; ... Show all
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