| The larva of hookworm matures into the adult stage in the small intestine, causing chronic intestinal blood loss and iron-deficiency anemia. Hookworm infestation of colon has not been reported previously. We report a 35-year-old man who presented with diarrhea with blood and mucus in stools. colonoscopy revealed several hookworms in the colon firmly adherent to the mucosa, with oozing of blood and surrounding mucosal erosions. He was treated with mebendazole and symptoms recovered completely. ( info) |
2/11. Human eosinophilic enteritis caused by dog hookworm ancylostoma caninum. An epidemic of eosinophilic enteritis (93 cases) has occurred in Townsville, northern queensland, australia. A hookworm was found attached to a resected, inflamed ileal segment from 1 patient but the species could not be identified. An adult hookworm of species ancylostoma caninum was recovered at colonoscopy from the terminal ileum of a later patient. All of 38 patients interviewed in an epidemiological survey described behaviour which could have exposed them to infective larvae of this widespread dog parasite. ( info) |
| A case of persistent folliculitis in a 21-year-old man was demonstrated to be due to ancylostoma caninum larvae. Treatment with oral thiabendazole was curative. Cutaneous larva migrans may be due to A caninum, but this presentation appears to be unique. The literature concerning etiology and pathogenesis of larva migrans is discussed with reference to this case. ( info) |
4/11. Eosinophilic enteritis presenting as surgical emergencies: a report of six cases. Eosinophilic enteritis is now commonly diagnosed in northern queensland, and cases have been seen elsewhere. The patients present with acute abdominal symptoms, which may mimic appendicitis, and many cases are managed by surgery. To facilitate the diagnosis of this unusual syndrome, six surgically treated cases are reported here. blood eosinophilia may be a helpful diagnostic feature, but in some cases it does not develop until after the acute abdominal episode. Most cases resolve satisfactorily with conservative management. ( info) |
5/11. Imported parasitic infections in tasmania. A number of protozoan, trematode, and nematode infections have been imported into tasmania over an 18-month period. Some of the cases are briefly discussed as they provide features of clinical interest. The increasing problem of imported infections in australia is emphasized. ( info) |
6/11. An unusual outbreak of hookworm disease in North india. An unusual outbreak of hookworm disease occurred after a game of "kabaddi" (a local game which results in much body contact with the ground) in 27 young males from one village. It was characterized by an immediate incapacitating dermatitis, followed by severe pulmonary symptoms. Progressive weakness, abdominal pain, weight loss and anemia developed within a few months. ancylostoma duodenale was found in all except four patients who had received antihelminthic treatment. Specific treatment for hookworm resulted in complete clinical recovery. Features of the outbreak were: 1) the hitherto unrecorded mode of infection; 2) severe dermatitis; 3) pulmonary symptoms lasting more than 3 mo; 4) abdominal symptoms suggestive of subacute obstruction starting 4-6 mo after exposure; and 5) severe disability with weight loss for a period of 1 yr until specific treatment was administered. ( info) |
7/11. ancylostoma larva in a muscle fiber of man following cutaneous larva migrans. This is a report of a case of massive cutaneous larva migrans in a 20-year-old man who also had pulmonary symptoms and larval invasion of the skeletal muscles. In sections of a muscle biopsy specimen taken 3 months after the initial cutaneous lesions, a third-stage ancylostoma larva, probably A. caninum, was found within a muscle fiber. ( info) |
8/11. Human enteric infection with canine hookworms. OBJECTIVE: To describe a zoonotic ancylostomiasis (canine), acquired from domestic pets by patients living in developed, urban communities. DESIGN: An 8-year, retrospective case study. SETTING: A clinical gastroenterologic practice in Townsville and a university parasitology department in Brisbane, australia. patients: Nine patients, each with enteric hookworm infection diagnosed by finding a single organism in situ; five were treated by us, and the rest were referred to us for parasite identification. MEASUREMENTS: Clinical and demographic data, complete blood examinations, total serum immunoglobulin e assay, and serologic testing with enzyme-linked immunosorbent assay and Western blot using excretory-secretory antigens of ancylostoma caninum. Gut biopsy specimens were examined histologically, and hookworms were identified using morphologic criteria. RESULTS: The infections in three of the patients were diagnosed during the initial 6 years and six in the last 2 years. All owned a dog and described activity potentially exposing them to infection with canine hookworm larvae. Three patients had a laparotomy for acute abdominal pain, and six had colonoscopies (five with pain and one without symptoms). Six of the nine had blood eosinophilia (mean, 0.97 x 10(9)/L), and five of eight had elevated immunoglobulin e levels (mean level, 756 micrograms/L); six of eight had eosinophilic inflammation of the gut. In six patients, the worm was identified as A. caninum, whereas in three, damage to the specimen did not allow specific identification; however, they were unlikely to be human parasite species. Although all parasites were in the adult stage, none were sexually mature. Positive serologic findings in seven of the eight patients tested confirmed presence of antibody to the parasite. CONCLUSIONS: Human enteric infections with A. caninum are being diagnosed more frequently in northeastern australia. Although infection may be subclinical, the chief symptom is abdominal pain, sometimes sudden and severe. The pathologic finding is focal or diffuse eosinophilic inflammation caused by a type 1 hypersensitivity response to secreted antigens. Infection by sexually immature worms is scant and nonpatent, indicating poor adaptation to the human host. Serologic testing assists in identification of occult infection. Advanced hygiene and sanitation afford little protection because the parasite reservoir is a large and growing pool of infected domestic pets. ( info) |
9/11. Transmammary passage of strongyloides sp. larvae in the human host. The prevalence of infection with strongyloides fuelleborni and hookworms (ancylostoma duodenale and necator americanus), and the possible transmammary passage of these parasites, was studied in the people of a village in Bulape, Zaire, africa. Stool examinations revealed that 34% of 76 infants under 200 days of age were infected with S. fuelleborni and 8% were infected with hookworms. Infection rates in the general population were 44% for S. fuelleborni and 90% for hookworms. The examination of milk from nursing mothers revealed the presence of strongyloides larvae in one case. The finding suggests that S. fuelleborni may be transmitted via the milk in humans. ( info) |
| Cutaneous larva migrans is considered to be a self-limited parasitic infection of about 2 to 8 weeks' duration, though it has been reported to persist for as long as 55 weeks. In this case, a healthy 47-year-old white man had multiple serpiginous lesions typical of cutaneous larva migrans for 18 months. A biopsy taken 2 months before presentation showed a parasite consistent with ancylostoma species deep in a hair follicle. The patient initially responded to topical thiabendazole, but relapse occurred when therapy was discontinued. Oral thiabendazole cured the problem after 22 months of infestation. Cutaneous larva migrans may sometimes be long-standing, here almost 2 years, even in a healthy patient. Organisms may reside deep in the hair follicles. Topical thiabendazole may not penetrate to this depth, necessitating oral thiabendazole therapy. ( info) |