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Hookworm infestation diagnosed by capsule endoscopy (with video)

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Cited by (10)

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    Citation Excerpt :

    Eventually we found the worms by endoscopy. There have been a number of previous cases, where endoscopy was used to detect worms in patients with gastrointestinal symptoms (abdominal pain, epigastric discomfort, and intestinal bleeding) in the literature.15–26 In most of these cases, worms were identified in the small intestine and only one study reported finding hookworms by colonoscopy.26

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Commentary

It is estimated that 1 billion people are infected with hookworm, mostly Necator americanus and Ancylostoma duodenale. After the third-stage larvae penetrate the skin and migrate to the lungs, they eventually penetrate alveoli and are swallowed, passing into the small bowel, where they mature. Mature worms mate and lay eggs: N americanus ∼10,000 per day and A duodenale ∼20,000 per day for more than 10 years! Hookworms graze on the mucosa, feeding on host blood. Blood consumption is estimated at up to 0.04 mL per day for N americanus and up to 0.3 mL per day for A duodenale; some hookworm species (Ancyclostoma caninum) also may cause eosinophilic enteritis and aphthae. In this case, the cause of the melena is unclear, especially because it wasn't noted on the capsule endoscopy. I will look with interest for future evaluations of the small bowel in hookworm infection.

Lawrence J. Brandt, MD

Associate Editor for Focal Points

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