Hookworm

Transmission:

• Penetration of unbroken skin (using an elastase) often of feet.
• Oral ingestion on unwashed vegetation (more common with Ancylostoma than Necator)
• Skin-> blood -> lungs -> cough into pharynx -> small intestine

Clinical

• Anemia and hypoalbuminemia
• Dry cough
• Skin: “Ground itch”

Investigations: eosinophilia, anaemia, sometimes bloating/diarrhoea

Treatment: albendazole, mebendazole

Identification:

• L1 larvae: rhabitiform, double-bulbed esophagus, deeper buccal invagination than strongyloides
• L3 “filariform”
• Necator americanus: cutting plates
• Ancylostoma duodenale: pointy teeth