Introduction 

-Hookworm disease is caused by the Infection with the hookworms Ancylostoma duodenale and Necator americanus

-Adult hookworm possess two pairs of teeth in the buccal capsule 

-Male hookworm has a characteristic copulatory bursa 

-Infectious larvae present in soil penetrate the skin, enter bloodstream, reach the lungs, invade the alveoli, ascend the airways, are swallowed, reach the intestines, mature into adult worms, attach to the mucosa, and suck blood

Symptoms & Signs 

Most infected persons are asymptomatic

Skin: Initial skin infection by the larval penetration may cause a pruritic maculopapular rash (ground itch) and serpiginous tracks of subcutaneous migration (cutaneous larva migrans) 

Lungs: Pulmonary symptoms during larval migration through the lungs include fever, cough and wheezing 

Gastrointestinal: Abdominal pain, anorexia, nausea, vomiting, diarrhea, ascites 

Hematological: Hypochromic microcytic anemia, eosinophilia, hypoalbuminemia

Diagnosis 

Diagnosis is based on the identification of characteristic eggs in feces

Adult worms: Ancylostoma duodenale possesses four sharp tooth-like structures, whereas N americanus has dorsal and ventral cutting plates;  the males have a unique fan-shaped copulatory bursa

Labs: Microcytic anemia, occult blood in the stool, hypoalbuminemia, eosinophilia 

Treatment 

Effective agents: Albendazole, Mebendazole, Pyrantel pamoate