ancylostoma duodenale

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					Hookworms
          Hookworms

- is one of the major parasitic disease. At
 least two species of hookworms infect
 man,      Necator     americanus      and
 Ancylostoma duodenale. They live in
 small intestine.
     Epidemiology

.
 Worldwide distribution. 22-26℃ is the optimal temperature
for Ancylostoma duodenale development, 31-35℃ is suitable
for Necator americanus




        Adults of A. duodenale   Adults of N. americanus
      II. Life Cycle

1. Final host: man
2. Inf. Stage: filariform larva
3. Inf. Route: by skin for both or
 contaminated food and water for
 duodenale
4. Site of inhabitation: small intestine
5. Life span: Ad 15years, Na 3-7years
Life cycle of hookworm
  III. Pathogenesis and Clinical Manifestations
• 1. Larval migration
   (1) Dermatitis, known as "ground itch" or
  "stool poison".The larvae penetrating the skin
  cause allergic reaction, petechiae 0r papule
  with itching and burning sensation. Scratching
  leads to secondary infection.
              Cont…
• (2) Pneumonitis (allergic reaction),
  Loeffler syndrome (cough, dyspnea,
  pleurisy, little or no fever, and
  eosinophilic pulmonary infiltrates) ,
  asthma, low fever, blood-tinged
  sputum or hemoptysis, chest-pain,
  inflammation shadows in lungs under
  X-ray.
• These manifestations go on about 2
  weeks.
                 Cont..
• Hypoproteinemia : Because of the
  clinically significant blood loss and
  the ingestion of serum proteins
  (manifests as weight-loss, anasarca,
  and edema).
• Blood loss: Inhibited host
  coagulation due to a series of
  anticoagulants
       2. Adults in small intestine

  (1) Epigastric pain as that of a duodenal ulcer.

  (2) A large worm burden results in microcytic hypochromatic
  anemia (character manifestation). The symptoms are
  lassitude, edema, palpitation of the heart. In severe case,
  death may result from cardiac failure or physical exhaustion.
  (3) Gastrointestinal bleeding causing anemia –microcytic
  hypochromic .
  (4) Infantile hookworm disease- when the worm load is very
  high
Sometimes children may develop a yellow green pallor known
  as “chlorosis” .A duodenale infection during infancy may be
  associated with diarrhoea , failure to thrive ,and severe
  anemia.
Adults in intestinal mucosa
Bleeding of intestinal wall
              Iv. Diagnosis

1.Identifying the characteristic oval hookworm
  eggs in the feces .
   However the eggs of the 2 species are
  indistinguishable.
2. Blood examination reveals microcytic ,
  hypochomic      anemia     occasionally   with
  eosinophila.
3. Hypoalbuminemia seen in heavy infection.
               Treatment
Eradication of the worm is achieved by:
1. Albendazole (400 mg once for all age )
2. 2. Mebedazole(100 mg twice a day for 3
   days)
3. Pyrantel pamoate     (11mg /kg once daily
   for 3 days)
4. Anemia is treated with oral iron therapy.
5. Severe anemia may require packed cell
   trasfusion.
              Prevention

Unified measures:
1.Sanitary disposal of night soil,
2.Individual protection,
3.Health education,
4.Cultivate hygienic habits,
5.Treat the patients and carriers.

				
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posted:6/27/2012
language:English
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