Ancyclostoma and Necator

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Key Points

  • Ancylostoma spp., Necator americanus
    • Characteristics
      • Also known as hookworms
      • Type of nematode (roundworm) parasite
    • Transmission
      • Found in soil contaminated with human feces
        • Larvae penetrate skin of barefoot walkers
        • Endemic to tropics and subtropics
    • Pathogenesis and Presentation
      • Skin irritation at site of skin invasion
        • Focal pruritic eruption
        • Cutaneous larva migrans
          • Serpiginous tracks of intracutaneous larval migration
          • Usually with animal hookworms, which do not survive to cause disease elsewhere
      • After entering the foot, migrate via blood to the lungs and through trachea
        • Usually asymptomatic
      • Larvae are swallowed and mature into adult worms in intestinal walls
        • Anemia
          • Caused by worms sucking blood from intestinal walls
        • Nausea/vomiting, diarrhea, abdominal pain, flatulence are seen
      • Eosinophilia
        • Non-specific; seen in many parasitic infections
    • Diagnosis
      • Stool microscopy (O&P)
        • Eggs are seen in stool
    • Treatment
      • Bendazoles
        • Albendazole and Mebendazole are used first-line
      • Pyrantel pamoate
        • Alternative first-line treatment; preferred in pregnancy