Hookworms Flashcards
Two primary intestinal hookworm species:
○ Ancylostoma duodenale
○ Necator americanus
Final Host
Man
MOT
Skin penetration
- undergoes Heart-lung Migration
For Ancylostoma:
- transmammary (breast milk)
- transplacental
Habitat
small intestine
Infective Stage
L3 filariform larva
Diagnostic Stage
Hookworm Eggs
Species
Identification
dental pattern/buccal cavity
eggs are ____________
indistinguishable
Ancylostoma duodenale
Common Name
Old World Hookworm
Ancylostoma duodenale
Prevalence
Found in European Countries
Ancylostoma duodenale
Shape
C-shaped curvature
Ancylostoma duodenale
Lifespan
5-7 years
Ancylostoma duodenale
Color
In fresh specimens, they are colored as
pinkish or creamy grey
Ancylostoma duodenale
Egg Productio
Females produce more or less 3000
eggs (value varies depending on
reference)
Ancylostoma duodenale
Comparison
Ancylostoma duodenale is bigger than
Necator americanus
Ancylostoma duodenale
Female worm; tail is ______ and has a mouth
pointed
Ancylostoma duodenale
Male worm; has a _________ and a mouth
copulatory bursa
Necator americanus
Common Name
New World Hookworm/American
Murderer
Necator americanus
Prevalence
Found in tropical areas
Necator americanus
Size
Smaller than Ancylostoma
duodenale
Necator americanus
Shape
S-shaped curvature
Necator americanus
Color
It may appear as greyish yellow with
reddish undertone
Necator americanus
Lifespan
4-20 Years
Necator americanus
Dental Pattern
No teeth but
semilunar cutting
plates are visible
Necator americanus
Copulatory
Bursa (found in
the male)
Bipartite/bidigitate
dorsal ray
Necator americanus
Spicule (male)
barbed and fuzed
together
Ancylostoma duodenale
Spicule (male)
plain and bristle
like
Ancylostoma duodenale
Copulatory
Bursa (found in
the male)
Tripartite/trudigitate dorsal rays
Ancylostoma duodenale
Dental Pattern
Has 2 pairs of
teeth
Hookworms: Larval Stages
It is the feeding stage
Rhabditiform Larva (L1 larva)
Hookworms: Larval Stages
It is quite stout
Rhabditiform Larva
(L1 larva)
Hookworms: Larval Stages
Check the _______ to identify L1 Larva
Rhabditiform Larva
buccal capsule
Hookworms: Larval Stages
Take note of the length: the buccal capsule is _______ than the width of the larva
Rhabditiform Larva
longer
Hookworms: Larval Stages
A small _________ is present in L1 larva of hookworms
Rhabditiform Larva
genital primordium
Hookworms: Larval Stages
Infective Stage
Filariform Larva (L3 larva)
Hookworms: Larval Stages
Close mouth stage
Filariform Larva (L3 larva)
Hookworms: Larval Stages
Slender compared to L1 Larva
Filariform Larva (L3 larva)
Hookworms: Larval Stages
On the posterior part, tail is _______ and the larva is
__________
Filariform Larva (L3 larva)
- pointed
- sheathed
Hookworm: Eggs
Thick or Thin shelled?
Thin-shelled
Hookworm: Eggs
round structures inside the egg
Blastomere
Hookworm: Eggs
Also called Morula ball formation
Blastomere
Hookworm: Eggs
____ developing cells are found in a single
egg
Blastomere
2 - 8
Hookworm: Eggs
It can be found and recovered in the ____ of infected patients
stool
Hookworm: Eggs
Just like Ascaris and Trichuris, hookworms are soil transmitted helminths and the eggs __________ in the soil.
embryonates
Hookworm: Eggs
_________ are recovered in the stools of patients.
Unembryonated eggs
Hookworm: Life Cycle
Get the infection if _____ penetrates the skin
L3 Larva
Hookworm: Life Cycle
__________ secreted by the L3 larva may allow penetration of larva to the skin and eventually end up into the bloodstream
Hyaluronidase
Hookworm: Life Cycle
From the bloodstream, the parasite would undergo
___________
heart lung migration.
Hookworm: Life Cycle
Larva will become mature worms found in the ___________ until they become adults.
small intestine
Hookworm: Life Cycle
Male and Female worms will undergo reproduction and release _________
unembryonated eggs.
Hookworm: Life Cycle
Once the unembrynated eggs are in the soil, they will embryonated for _______ and the L1 larva would
be released
1 to 2 days
Hookworm: Life Cycle
Hookworms prefer embryonating in __________
sandy
loam soil
Hookworm: Life Cycle
Egg will hatch into an _________ and will become an _____ in the soil ready to infect another host
- L1 larva
- L3 larva
Hookworm: Life Cycle
When reporting, only write it as
“Hookworm Eggs”
Hookworm: Pathology
3 Phases:
- Cutaneous Phase
- Pulmonary Phase
- Intestinal Phase
Hookworm: Pathology
Pulmonary Phase:
Wakana’s Disease
(Pneumonitis)
Hookworm: Pathology
Cutaneous Phase:
Ground itch
(Allergic Reaction)
or Dew Itch
Hookworm: Pathology
Intestinal Phase:
- Blood Loss (IDA)
- Abdominal Pain
- Diarrhea
- Eosinophilia
Hookworm: Pathology
Happens during the larval penetration of the
skin
Cutaneous Phase
Hookworm: Pathology
would usually appear as redness or rash on
the skin (a papular rash)
Cutaneous Phase
Hookworm: Pathology
It would be seen at the soles of the feet or in
between the toes.
Cutaneous Phase
Hookworm: Pathology
The redness is caused by the allergic
reaction against the larvae antigens of the parasite
Cutaneous Phase
Hookworm: Pathology
This disease is also a type of Pneumonitis that is quite similar to Ascaris due to the migrating larva
Pulmonary Phase
Hookworm: Pathology
Elevation of Eosinophils
Pulmonary Phase
Hookworm: Pathology
Respiratory manifestations
Pulmonary Phase
Hookworm: Pathology
Presence of Charcot Leyden crystals in the
sputum specimen
Pulmonary Phase
Hookworm: Pathology
Attributed to the adult worms. The adult hookworm will attach to the small intestines and suck blood – leading to blood loss.
Intestinal Phase
Hookworm: Pathology
Chronic cases can lead to:
Intestinal Phase
■ Iron Deficiency Anemia
■ low hemoglobin count
■ Red cells would become
microcytic
■ Color would be hypochromic
(paler in color)
Hookworm: Pathology
Some conditions such as ___________ and __________ can exacerbate the manifestations – more blood loss
pregnancy and menstruation
Hookworm: Treatment
- Albendazole
- Mebendazole
- Pyrantel Pamoate
Hookworm: Pathology
More blood loss will be encountered if infected with ___________ due to its large size.
Ancylostoma duodenale
Hookworm: Diagnosis
● DFS
● Kato-Katz
● Concentration Techniques (FECT)
● Baermann Technique
Hookworm: Diagnosis
It can be for the determination of the
intensity of infection
Kato-Katz
Hookworm: Diagnosis
Quantifies the eggs per gram
Kato-Katz
Hookworm: Diagnosis
For the recovery of eggs
Concentration Techniques (FECT)
Hookworm: Diagnosis
For recovery of larvae
Baermann Technique
Hookworm: Diagnosis
It make use of a Baermann funnel
Baermann Technique
Hookworm: Diagnosis
this has a gauze and a wire mesh (cheesecloth is an alternative for the gauze)
Baermann funnel
Hookworm: Diagnosis
can examine more amounts of stool vs.
Harada Mori Technique
Baermann funnel
Hookworm: Diagnosis
can examine larval stages of Strongyloides
Baermann funnel
Hookworm: Diagnosis
can also examine soil
Baermann funnel
Hookworm: Diagnosis
In the gauze, __________ will be put inside. You will tali and put it inside the funnel
Baermann Technique Steps
fecal matter
Hookworm: Diagnosis
In the funnel, there is the wire mesh and make sure that the lower part of the funnel is ________ to prevent fluid or fecal matter to flow
Baermann Technique Steps
clipped
Hookworm: Diagnosis
Afterwards, put _____ into the funnel, and put in a room temperature. Wait for a few days.
Baermann Technique Steps
water
Hookworm: Diagnosis
The eggs in the fecal matter will hatch and the larva will be accumulated in the _____
Baermann Technique Steps
fluid
Hookworm: Diagnosis
After few days of accumulation, collect the fluid in a beaker. ________ it, and look for larval stages
Baermann Technique Steps
Centrifuge
Hookworm: Diagnosis
also for recovery of larvae
Harada Mori Technique
Hookworm: Diagnosis
stool samples for this technique should not
be refrigerated
Harada Mori Technique
Hookworm: Diagnosis
Requires a filter paper to which fecal
material is added and a test tube into which the filter paper is inserted.
Harada Mori Technique
Hookworm: Diagnosis
Moisture is maintained by adding boiled or
distilled water
Harada Mori Technique
Hookworm: Diagnosis
With a strip of __________ with fecal smear, put it inside a conical tube with distilled water
Harada Mori Technique Steps
filter paper
Hookworm: Diagnosis
Make sure the distilled water will not touch
the _________
Harada Mori Technique Steps
fecal smear
Hookworm: Diagnosis
Put a ____ plug
Harada Mori Technique Steps
cotton
Hookworm: Diagnosis
Put in an upright position in a dark area for _____ at room temperature.
Harada Mori Technique Steps
5-7 days
Hookworm: Diagnosis
Hookworm eggs will hatch and the larva will migrate and be recovered in the _____.
Harada Mori Technique Steps
water
Hookworm: Diagnosis
Examine the water everyday or every other day to check for the _______ presence.
Harada Mori Technique Steps
larva’s
Hookworm: Diagnosis
Prior examination, ____ the water when checking in order to kill the larval stages
Harada Mori Technique Steps
heat
Hookworm: Diagnosis
If freshly collected, we would find the _____. we would rarely find larva
Harada Mori Technique Steps
eggs
Hookworm: Diagnosis
If sample is old/not fresh, we would now find ____
Harada Mori Technique Steps
larva
Hookworm: Epidemiology
______ are more prone to infection
Farmers
Hookworm: Epidemiology
______ and ______ are high risk
Pregnant Women and Children
Hookworm: Epidemiology
Pregnant women would need more ____
iron
Hookworm: Epidemiology
Eggs embryonate best in damp sandy loam soil and at a temperature of ____
24-32C
Hookworm: Epidemiology
Other modes of transmission has been observed in for _______
Old World Hookworm