BY NEENUMOL VELAYUDHAN

ANCYCLOSTOMA DUODENALE
 THE OLD WORLD HOOKWORM.

 DISCOVERED BY ANGELO DUBINI.

 LOSS-Pathogenesis and mode of entrance.

 DISTRIBUTION-EUROPE,NORTH
AFRICA,INDIA,SRILANKA AND CHINA.
 HABITAT

 SMALL INTESTINE OF MAN-ADULTWORM.

 PARTICULARLY IN JEGUNUM.

 OFTEN IN DUODENUM.

 RARELY IN ILEUM.
MORPHOLOGY
 ADULT WORM

 EGG

 LARVAE
ADULT WORM
 Small, greyish white,cylindrical worm.

 reddish brown due to injested blood.

 Ant end has bend,hence hook worm.

ADULT WORM
 Adult female is about 12.5 mm, and the male is
about 8mm.
 The anterior end have buccal capsule
(analogous to mouth) armed with two ventral
pairs of teeth.
 The posterior end of the male has copulatory
bursa to attach the female during the copulation,
females have simple conical tail.
ADULT WORM
.
EGG
• Shape : oval with an empty space between the
shell and content
• Size: 60 x 40 μm
• Shell: thin egg shell
• Color: colorless and transparent
• Content: 4-8 cell unembryonated
• Immature eggs pass in feces (20,000 eggs ⁄
day).
LARVAE
Rhabditiform larva:
-thin
-size: 200-400µ
-long buccal cavity.
-rhabditiform oesophagus, very small genital
-pointed tail end.

Filariform larva:
-size: 600-700µ.
-cylindrical oesophagus( one third of the
body length)
-sharply pointed tail
LIFE CYCLE
STAGE1. Passage of eggs-Eggs are passed in the stool

STAGE2. Development in soil- Under favorable

conditions like moisture,shade ect.larvae hatche in 1 to
2 days.The rhabditiform larvae grow in the feces or
soil.

STAGE3. Entrance into a new host-After 5 to 7 days

they become filariform that are infective, On contact
with the human host, the larvae penetrate the skin
STAGE4. Migration- .Carried through the blood
vessels to the heart and then to the lungs. They
penetrate into the pulmonary alveoli, ascend the
bronchial tree to the pharynx, and are swallowed.

STAGE5. Localization and laying of eggs- The

larvae reach the small intestine, where they reside
and mature into adults. Adult worms live in the
lumen of the small intestine, where they attach to
the intestinal wall with resultant blood loss by the
host
DISEASE
 HOOK WORM DISEASE OR
ANCYCLOSTOMIASIS CHARECTERISED
CHIEFLY BY ANEMIA
MODE OF INFECTION
 Occurs when walks bare-foot on the faecally
contaminated soil.
 The filariform larvae penetrates skin with
which they come in contact.
most common sites of entry are,
1.The thin skin btw toes.
2.The dorsum of feet.
3.The inner side of sole.
 Also occur by accidental drinking of water
contaminated with filariform larvae.
CONT…
 Infective agent – FILARIFORM LARVAE

 Migration – Though LUNGS

 Portal entry – Skin

 Site of location – Small intestine

PATHOGENCITY
 PATHOGENIC EFFECTS
1.Caused by Ancyclostome
Larvae
2.Caused by Adult worm in
small intestine
PATHOGENIC EFFECTS CAUSED BY
ANCYCLOSTOME LARVAE

A. Lesions in skin
1.Ancyclostome dermatitis
2.Creeping eruption
B. Lesions in the lungs
1.Bronchitis
2.Broncho-pneumonia
LESIONS IN SKIN
 ANCYCLOSTOME DERMATITIS –GROUND
ITCH
 Occurs at the site of entry
 Disappears in the course of 1 to 2 weeks
CONT..
 CREEPING ERUPTION
 filariform larvae wander about through
the skin in an aimless manner for several
weeks and months, producing a reddish
itchy papule along the path traversed by the
larvae – ‘larva migrans’.
LESIONS IN THE LUNG
 Bronchitis and Broncho-pneumonia may
occur when the larvae breaks through the
pulmonary capillaries and enter alveolar
spaces.
PATHOGENIC EFFECTS CAUSED BY
ADULT WORM
 Adult worm inhabit small intestine of man,
battaching themselves to the mucous
membrane by means of their powerful
buccal armature.
 Microcytic hypochromic type anemia
develops in course of time.
CAUSES OF ANEMIA
Chronic blood loss – due to withdrawal of
blood by the parasites, chronic hemorrhages
from punctured sites

Nutritional defects
Clinical Features of Hook Worm
Anemia
 GI Manifestations
1.Epigastric tenderness stimulting duodenal ulcer
2.Pica
 Effects of Anemia
1.skin-light yellow with mucous membrane of eye,
lips, and tongue extreme pallor
2.Koilonychia-frequently
3.Protruberant abdomen and dry lustreless
hair
LAB DIAGNOSIS
 SAMPLES COLLECTED- Stool, Blood

 DIRECT METHODS
1. Examination of stool
I. Macroscopic examination- To find out the adult
worm
II. Microscopic examination -To demonstrate
hookworm eggs
2. Study of duodenal contents

 Material obtained by duodenal intubation may

sometimes reveal either eggs or the adult worms.

 INDIRECT METHODS
1.Examination of blood
 Carried out to ascertain –Nature of anemia and presence
of eosinophilia.
2.General examination of stool
 Test for ocult blood,Charcot-Leyden crystals.
SPECIFIC DIAGNOSIS- Studying adult worm morphology
or the mature infective filariform larvae.
TREATMENT
A. Expulsion of worms
Anthelmintic(hb abv 30%)
1. THIABENDAZOLE 25mg/kg for two days
2. PYRANTEL PAMOATE 10mg/kg for 3 days
3. MEBENDAZOLE 100mg bid for 3 days
4. ALBENDAZOLE 400mg once
CONT..
B. Treatment of anemia

1. Oral iron (ferrous sulphate 200 or 400 mg tid

daily ,according to tolerance of the patient).
2. Folic acid and Vitamine B12 may be indicated in
some cases.
PROPHYLAXIS
1. Attack on Adult Parasite-treatment of
carrier diseased

2. Attack on Larvae- Proper control of sewage

disposal.

3. Personal Protection-Wearing of boots and

glove.