Ankylostomiasis B76.00

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 18.12.2020

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Synonym(s)

Chlorosis Egyptian; Egyptian chlorosis; hookworm disease; Hookworm disease; miner's worm disease; Tunnel anaemia

History
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Dubini, 1843; Griesinger, 1854

Definition
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Parasitosis caused by hookworms - hookworm disease.

Pathogen
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Ancylostoma duodenale (old world hookworm), Ancylostoma braziliense and Necator americanus (new world hookworm).

Occurrence/Epidemiology
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About 50 million patients worldwide are symptomatically ill; 400-900 million people are asymptomatic hosts. Spread worldwide, especially in the tropics and subtropics. In endemic areas, up to 90% of the population is affected.

Etiopathogenesis
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Active percutaneous invasion of hookworm larvae on uncovered skin. Subsequent larvae migrate by bloodstream into pulmonary vessels (heart-lung passage) and after leaving them via alveoli, bronchia, trachea and pharynx into the small intestine. There they develop to sexual maturity. Adult hookworms attach themselves to the mucous membrane and suck blood.

Manifestation
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It is common among miners, tunnel and brick workers, coffee plantation workers.

Clinical features
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Inflammation of the skin at the point of larval penetration. Frequently eczematization and superinfection of the lesions by scratching, urticaria. Later, depending on the larvae' migration routes, lung symptoms, anaemia, heart failure, digestive disorders, malnutrition may occur.

Laboratory
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Eosinophilia, anemia.

Diagnosis
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Detection of the worm eggs in fresh faeces.

External therapy
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  • Tiabendazol: Successes have been described with a 10% aqueous Tiabendazol solution (e.g. Mintezol) 4-5 times/day for 1 week external application. 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 addition R252 ) under occlusion (2 times 4 hours per day) is recommended, therapy duration 5-7 days.
  • The external freezing methods (liquid nitrogen in spray or closed contact procedure, see also cryosurgery) have more side effects and are less effective than Tiabendazol.

Internal therapy
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Albendazole (Escazole): 400 mg p.o. as ED. Alternatively: Pyrantel (e.g. Helmex) single ED of 10 mg/kg bw/day (max. 1 g). Alternatively: Mebendazole (e.g. Vermox) 2 times/day 100 mg for 3 days or Ivermectin (Mectizan): 150-200 μg/kg KG p.o. as ED.

Progression/forecast
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Untreated and usually lethal after long lasting strong infestation.

Literature
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  1. 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
  2. Brenner MA et al (2003) Cutaneous larva migrans: the creeping eruption. Cutis 72: 111-115
  3. Caumes E et al (1992) Efficacy of ivermectin in the therapy of cutaneous larva migrans. Arch Dermatol 128: 83-87
  4. 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
  5. Dubini A (1843) Nuovo verme intestinal umano (Agchylostoma duodenale) constituente un sesto genere die nematoidea propri dell' uomo. Ann Universali Med 106: 5-13
  6. Griesinger W (1854) Clinical and anatomical observations on the diseases of Egypt. Arch Physiol Heilkd 13: 528-575
  7. 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
  8. Ponnighaus JM et al (2000) Pruritus of dark skin in hookworm infection. dermatologist 51: 953-955

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 18.12.2020