Hookworms Clinical Presentation

  • Author: David R Haburchak, MD; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Nov 22, 2011
 

History

Most individuals who develop hookworm infection are from known endemic areas.

  • Early symptoms of hookworm infection are proportional to the intensity of exposure.
  • Necator produces a local irritation, termed ground itch, at the site of skin invasion. An intensely pruritic, erythematous, or vesicular rash usually appears on the feet or hands. This should be distinguished from a creeping eruption due to skin migration of the cat or dog hookworm Ancylostoma braziliense. See the image below. Ground itch associated with skin penetration of hoGround itch associated with skin penetration of hookworm larvae.
  • Severe infection with either A duodenale or N americanus may produce pneumonitis (Loefflerlike syndrome) that manifests as cough, fever, and malaise.
  • As worms mature in the jejunum, patients may experience diarrhea, vague abdominal pain, colic, and/or nausea. These symptoms are more common with initial exposures than with subsequent exposures.
  • Patients with severe iron deficiency anemia may present with lassitude, headache, palpitations, dyspnea, and edema.
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Physical

  • Skin and pulmonary findings are minimal.
  • Signs of iron deficiency anemia are often insensitive. In severe cases, patients may exhibit pallor, spooning nails, tachycardia, and peripheral edema. Poor skin texture, edema, and susceptibility to cutaneous infection suggest possible malnutrition.
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Contributor Information and Disclosures
Author

David R Haburchak, MD  Program Director, Professor, Department of Internal Medicine, Division of Infectious Disease, Medical College of Georgia

David R Haburchak, MD is a member of the following medical societies: Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Pranatharthi Haran Chandrasekar, MBBS, MD  Professor, Department of Internal Medicine, Director of Infectious Disease Fellowship, Harper Hospital, Wayne State University School of Medicine

Pranatharthi Haran Chandrasekar, MBBS, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Ronald A Greenfield, MD  Professor, Department of Internal Medicine, University of Oklahoma College of Medicine

Ronald A Greenfield, MD is a member of the following medical societies: American College of Physicians, American Federation for Medical Research, American Society for Microbiology, Central Society for Clinical Research, Infectious Diseases Society of America, Medical Mycology Society of the Americas, Phi Beta Kappa, Southern Society for Clinical Investigation, and Southwestern Association of Clinical Microbiology

Disclosure: Pfizer Honoraria Speaking and teaching; Gilead Honoraria Speaking and teaching; Ortho McNeil Honoraria Speaking and teaching; Abbott Honoraria Speaking and teaching; Astellas Honoraria Speaking and teaching; Cubist Honoraria Speaking and teaching; Forest Pharmaceuticals Speaking and teaching

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

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Adult hookworm attached to duodenal mucosa.
Life cycle of hookworms.
Ground itch associated with skin penetration of hookworm larvae.
 
 
 
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