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Ancylostoma duodenale and Necator americanus

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Ancylostoma duodenale and Necator americanus

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Chapter 82 Nematodes (Roundworms) ANCYLOSTOMA DUODENALE & NECATOR AMERICANUS osms.it/ancylostoma-duodenale osms.it/necator-americanus PATHOLOGY & CAUSES ▪ Infectious hookworm species Adult morphology ▪ Ancylostoma duodenale ▫ Two ventral plates on buccal capsule’s anterior margin; two large teeth fused at base (male 8–11mm, female 10–13mm long) ▪ Necator americanus ▫ Two dorsal/ventral cutting plates around buccal capsule’s anterior margin, paired subdorsal/subventral teeth (male 7–9mm, female 9–11mm long) ▪ A. duodenale, Necator americanus: most common hookworm species causing helminth gastrointestinal infection ▫ Light infection (< 100 worms) ▫ Moderate infection (100–500 worms) ▫ Heavy infection (500–1000 worms) ▪ Pathophysiology ▫ Hookworm attachment, hyaluronidase release → intestinal wall degradation, capillary laceration → anticoagulant peptides, inhibits platelet function inhibitor production → bleeding facilitation → extravasated blood ingested (approx. 0.5mL daily) ▫ Moderate–heavy infections → chronic iron-deﬁciency anemia; protein malnutrition Infectious form ▪ Filariform larva Life cycle ▪ Infectious form maturation ▫ Female A. duodenale lays 10,000– 30,000 eggs daily ▫ Female N. americanus lays 5,000– 10,000 eggs daily ▫ Human feces egge release → soil deposition → eggs hatch (24–48 hours—favorable conditions) → rhabditiform larvae (L1) → transformation to infectious ﬁlariform larvae (L3) in 5–10 days ▪ Human stages ▫ Filariform larvae skin penetration → passage through veins to heart, lung → pulmonary alveoli penetration, ascend bronchi to pharynx → coughed up/swallowed into small intestine → maturation → intestinal wall attachment via buccal capsule ▪ Some A. duodenale larvae undergo developmental arrest in gut tissues/muscle ▫ Await more favorable environmental conditions (hypobiotic larvae) ▪ Natural life-span ▫ A. duodenale: approx. one year ▫ N. americanus: 3–5 years Transmission ▪ Contaminated soil contact → percutaneous larval penetration ▪ Oral route ▪ Transmammary route RISK FACTORS ▪ Inadequate clean-water access ▪ Poor sanitary conditions ▪ Walking barefoot (endemic areas) COMPLICATIONS ▪ Severe iron-deﬁciency anemia; protein malnutrition → impaired growth, cognitive OSMOSIS.ORG 437

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Ancylostoma duodenale and Necator americanus

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A 20-year-old man comes to the physician for evaluation of severe itchiness in the right foot. The patient returned a week ago from a trip to Italy, during which he consumed raw seafood and walked barefoot on the beach. Temperature is 37.7°C (99.9°F), blood pressure is 115/73 mmHg, and pulse is 82/min. Physical examination reveals a serpiginous, pruritic rash at the lateral aspect of the right foot. Cardiac, pulmonary, and abdominal examinations are unremarkable. Which of the following is the most likely cause of this patient’s condition?

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