With the improvement of sanitation, the infection rate of hookworm is greatly reduced and the severe infected case is rarely reported. Combined morphological and molecular biological examinations, a severe hookworm infection patient was diagnosed in Department of Laboratorial Examination, Quanzhou First Affiliated Hospital of Fujian Medical University. The morphological methods such as direct fecal smear microscopy, saturated brine flotation and hookworm larvae culture methods were used to identify the eggs and larvae from stool samples of the patient. There were a large number of hookworm eggs in patient's stool samples, and the average count was 60 840 per gram by modified Kato method, which belonged to severe hookworm infection. Meanwhile, to distinguish the hookworm species, the semi-nested RT-PCR assay was employed to detect hookworm internal transcribed spacer series from eggs in patient's stool samples, and the result showed that the hookworm species was confirmed to be Necator americanus.
Ancylostomatoidea/genetics* ; Animals ; Feces ; Hookworm Infections/diagnosis* ; Humans ; Necator americanus/genetics* ; Polymerase Chain Reaction

Hookworm infections are rare causes of acute gastrointestinal bleeding. We report a middle aged man with primary nephrotic syndrome and pulmonary embolism. During the treatment with steroids and anticoagulants, the patient presented acute massive hemorrhage of the gastrointestinal tract. The results of gastroscopy showed red worms in the duodenum. Colonoscopy and CT angiogram of abdomen were unremarkable. Capsule endoscopy revealed fresh blood and multiple hookworms in the jejunum and ileum. Hookworms caused the acute intestinal bleeding. The patient responded well to albendazole. Hematochezia was markedly ameliorated after eliminating the parasites. Hence, hookworm infection should be considered in the differential diagnosis of a patient with obscure gastrointestinal bleeding. Capsule endoscopy may offer a better means of diagnosis for intestinal hookworm infections.
Abdomen ; Albendazole ; Ancylostoma ; Ancylostomatoidea* ; Anticoagulants ; Capsule Endoscopy ; Colonoscopy ; Diagnosis ; Diagnosis, Differential ; Duodenum ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Gastroscopy ; Hemorrhage* ; Hookworm Infections* ; Humans ; Ileum ; Jejunum ; Middle Aged ; Necator americanus ; Nephrotic Syndrome ; Parasites ; Pulmonary Embolism ; Steroids

Hookworm infections are widely prevalent in tropical and subtropical areas, especially in low income regions. In the body, hookworms parasitize the proximal small intestine, leading to chronic intestinal hemorrhage and iron deficiency anemia. Occasionally, hookworms can cause overt gastrointestinal bleeding, but this is often ignored in heavily burdened individuals from endemic infectious areas. A total of 424 patients with overt obscure gastrointestinal bleeding were diagnosed by numerous blood tests or stool examinations as well as esophagogastroduodenoscopy, colonoscopy, capsule endoscopy or double-balloon enteroscopy. All of the patients lived in hookworm endemic areas and were not screened for hookworm infection using sensitive tests before the final diagnosis. The patients recovered after albendazole treatment, blood transfusion, and iron replacement, and none of the patients experienced recurrent bleeding in the follow-up. All the 31 patients were diagnosed with hookworm infections without other concomitant bleeding lesions, a rate of 7.3% (31/424). Seventeen out of 227 patients were diagnosed with hookworm infections in the capsule endoscopy (CE), and 14 out of 197 patients were diagnosed with hookworm infections in the double balloon enteroscopy (DBE). Hookworm infections can cause overt gastrointestinal bleeding and should be screened in patients with overt obscure gastrointestinal bleeding (OGIB) in endemic infectious areas with sensitive methods. Specifically, the examination of stool specimens is clinically warranted for most patients, and the proper examination for stool eggs relies on staff's communication.
Albendazole ; Ancylostoma ; Ancylostomatoidea* ; Anemia, Iron-Deficiency ; Blood Transfusion ; Capsule Endoscopy ; Colonoscopy ; Diagnosis ; Double-Balloon Enteroscopy ; Eggs ; Endoscopy, Digestive System ; Follow-Up Studies ; Hematologic Tests ; Hemorrhage* ; Hookworm Infections* ; Humans ; Intestine, Small ; Iron ; Necator americanus ; Ovum

The present study was performed to reveal the current status and risk factors of Strongyloides stercoralis infections in the villages of Kenethao district, Xayaburi Province, Lao PDR. Fecal specimens were collected and examined for S. stercoralis using Koga-agar plate culture technique. Among 516 individuals, the prevalence of S. stercoralis and hookworm infection was 44.2% and 17.1%, respectively. Co-infection was detected in 13.2% of the cases. The prevalence did not significantly differ between males and females (P=0.193). However, the prevalence of S. stercoralis infection increased significantly with age (P=0.041). Of the risk factors examined, both performing farming activities (P=0.001) and walking barefoot when going outside of the house (P=0.003) showed significant correlations with S. stercoralis infections. Our results suggest that S. stercoralis is highly endemic in this area. The National Helminth Control Program of Lao PDR should take actions to control S. stercoralis infection. In addition, provision of health education about the benefits of wearing shoes would be important for reducing infection in the study area. Moreover, the application of high-sensitivity diagnostic approaches is needed to obtain the true impact of S. stercoralis infections in all rural communities in order to provide surveillance activities in Lao PDR.
Agriculture ; Coinfection ; Culture Techniques ; Female ; Health Education ; Helminths ; Hookworm Infections ; Humans ; Male ; Prevalence ; Risk Factors* ; Rural Population* ; Shoes ; Strongyloides stercoralis* ; Strongyloides* ; Walking

Hookworm infections as well as other intestinal nematodiases are endemic in China. In this case, a 70-year-old male showed symptoms of chest tightness, shortness of breath, and both lower extremities edema. The diagnostic result was chronic renal insufficiency, chronic kidney disease (5th stage), and renal anemia at first. Then, he received treatment with traditional drugs. However, this treatment did not help to alleviate the symptoms of the patient significantly. The results of gastroendoscopy showed hookworms in the duodenum, also confirmed by pathology examination. Anemia was markedly ameliorated after eliminating the parasites. The results mentioned above suggested that ancylostomiasis was the leading causes of anemia in this patient, and the etiology of anemia in uremic patients should be systematically considered. Especially when anemia could not be cured by regular treatments, rare diseases should be investigated.
Aged ; Ancylostomatoidea* ; Ancylostomiasis ; Anemia* ; China* ; Duodenum ; Dyspnea ; Edema ; Hookworm Infections ; Humans ; Lower Extremity ; Male ; Parasites ; Pathology ; Peritoneal Dialysis* ; Rare Diseases ; Renal Insufficiency, Chronic ; Thorax

A 26-year-old male member of the Australian Defense Force presented with a history of central abdominal pain of 4 weeks duration and peripheral eosinophilia consistent with eosinophilic enteritis. Acute hookworm disease was diagnosed as the cause. Adult worms recovered from feces after therapy with albendazole were morphologically consistent with Ancylostoma ceylanicum. As the patient had been deployed with the Regional Assistance Mission to Solomon Islands for 6 months prior to this presentation, it is very likely that the A. ceylanicum was acquired in Solomon Islands. Until now, it has been assumed that any Ancylostoma spp. recovered from humans in Solomon Islands is A. duodenale. However, this case demonstrates that human hookworm infection acquired in the Solomon Islands could be caused by A. ceylanicum.
Abdominal Pain ; Adult ; Albendazole ; Ancylostoma* ; Ancylostomatoidea ; Enteritis ; Eosinophilia ; Eosinophils ; Feces ; Hookworm Infections ; Humans ; Male ; Melanesia* ; Military Personnel*

To know the infection status of helminths in primary schoolchildren of southern parts of Vietnam, we performed an epidemiological study in Krong Pac district, Dak Lak Province, Vietnam. A total of 1,206 stool specimens were collected from ethnic Ede schoolchildren in 4 primary schools in 2015 and examined by the Kato-Katz technique. In addition, stool cultures were done by the Harada-Mori method to obtain hookworm larvae and then to clarify the species of hookworms infected. The results showed that the helminth infection rate was 25.0%, including 2.0% Ascaris lumbricoides, 0.33% Trichuris trichiura, and 22.8% hookworm infections. The average intensity of infection was 102.0 eggs per gram of feces (EPG) for Ascaris, 36.0 EPG for Trichuris, and 218.0 EPG for hookworms. ITS1 gene sequences of the hookworm larvae were identical with those of Necator americanus (100% homology) reported in GenBank. It has been confirmed in this study that the hookworm, N. americanus, is a dominant helminth species infected in primary schoolchildren of a southern part of Vietnam. Public health attention is needed for control of hookworm infections among schoolchildren in surveyed areas of Vietnam.
Ancylostomatoidea* ; Ascaris ; Ascaris lumbricoides ; Databases, Nucleic Acid ; Eggs ; Epidemiologic Studies ; Feces ; Helminths* ; Hookworm Infections ; Humans ; Larva ; Methods ; Necator americanus ; Ovum ; Prevalence* ; Public Health ; Trichuris ; Vietnam*

This study describes the first record of Globocephalus samoensis (Nematoda: Ancylostomatidae) recovered in wild boars from southwestern regions of Korea. Gastrointestinal tracts of 111 Korean wild boars (Sus scrofa coreanus) hunted from mountains in Suncheon-si, Gwangyang-si, and Boseong-gun between 2009 and 2012 were examined for their visceral helminths. G. samoensis, as identified by morphological characteristics of the head and tail, were recovered from the small intestine of 51 (45.9%) wild boars. Worms were found from 7 of 28 wild boars (25.0%) from Suncheon-si, 40 of 79 (50.6%) from Gwangyang-si, and all 4 (100%) from Boseong-gun. The length of adult females was 7.2+/-0.5 mm, and the thickest part of the body measured the average 0.47+/-0.03 mm, while those of males were 6.52+/-0.19 and 0.37+/-0.02 mm, respectively. The buccal cavity was equipped with a pair of large and bicuspid subventral lancets near the base of the capsule. The average length of spicules of males was 0.45+/-0.02 mm. By the present study, G. samoensis is recorded for the first time in southwestern regions of Korea. Additionally, morphological characteristics and identification keys provided in the present study will be helpful in the faunistic and taxonomic studies for strongylid nematodes in both domestic and wild pigs. The infection of G. samoensis apparently did not elicit pathologic lesions, as revealed by macroscopic observation during the autopsy of all wild boars in this study.
Ancylostomatoidea/anatomy & histology/*isolation & purification ; Animals ; Biometry ; Female ; Gastrointestinal Tract/parasitology ; Helminthiasis/epidemiology/parasitology ; Hookworm Infections/epidemiology/parasitology/*veterinary ; Intestinal Diseases, Parasitic/epidemiology/parasitology/*veterinary ; Male ; Microscopy ; Prevalence ; Republic of Korea/epidemiology ; Sus scrofa/*parasitology ; Swine ; Swine Diseases/*epidemiology/*parasitology

The 2 principal species of hookworms infecting humans are Necator americanus and Ancylostoma duodenale. Case studies on zoonotic hookworm infections with Ancylostoma ceylanicum and/or Ancylostoma caninum are known mainly from Asian countries. Of these 2 zoonotic species, only A. ceylanicum can develop to adulthood in humans. In the present study, we report a molecular-based survey of human hookworm infections present in southern and northeastern Thailand. Thirty larval hookworm samples were obtained from fecal agar plate cultures of 10 patients in northeastren Thailand and 20 in southern Thailand. Partial ITS1, 5.8S, and ITS2 regions of the ribosomal DNA genes were amplified using PCR. The amplicons were sequenced, aligned, and compared with other hookworm sequences in GenBank database. The results showed that, in Thailand, N. americanus is more prevalent than Ancylostoma spp. and is found in both study areas. Sporadic cases of A. ceylanicum and A. duodenale infection were seen in northeastern Thailand.
Ancylostoma/classification/genetics/*isolation & purification ; Ancylostomiasis/*epidemiology ; Animals ; Cluster Analysis ; DNA, Ribosomal Spacer/chemistry/genetics ; Feces/parasitology ; Humans ; Molecular Sequence Data ; Necator americanus/classification/genetics/*isolation & purification ; Necatoriasis/*epidemiology ; Phylogeny ; Polymerase Chain Reaction ; Prevalence ; RNA, Ribosomal, 5.8S/genetics ; Sequence Analysis, DNA ; Sequence Homology, Nucleic Acid ; Thailand/epidemiology

OBJECTIVETo develop a quantitative PCR method for detecting hookworm infection and quantification.

METHODSA real-time PCR method was designed based on the intergenic region II of ribosomal DNA of the hookworm Necator americanus. The detection limit of this method was compared with the microscopy-based Kato-Katz method. The real-time PCR method was used to conduct an epidemiological survey of hookworm infection in southern Fujian Province of China.

RESULTSThe real-time PCR method was specific for detecting Necator americanus infection, and was more sensitive than conventional PCR or microscopy-based method. A preliminary survey for hookworm infection in villages of Fujian Province confirmed the high prevalence of hookworm infections in the resident populations. In addition, the infection rate in women was significantly higher than that of in men.

CONCLUSIONSA real-time PCR method is designed, which has increased detection sensitivity for more accurate epidemiological studies of hookworm infections, especially when intensity of the infection needs to be considered.

Animals ; China ; epidemiology ; DNA, Helminth ; genetics ; Female ; Humans ; Male ; Microscopy ; Necator americanus ; genetics ; isolation & purification ; Necatoriasis ; diagnosis ; epidemiology ; genetics ; Nucleic Acid Amplification Techniques ; Real-Time Polymerase Chain Reaction ; Sensitivity and Specificity ; Sentinel Surveillance ; Sequence Analysis, DNA ; Sex Distribution