NEMATODES: Hookworms

General Info Hookworm (in General) Strongyloides stercoralis

CN Threadworm
FH Human/Nonhuman (Group) Man
H Small intestine Small intestines
Life Span Max: 15 years
MOT Ingestion (Human) Skin penetration
Skin penetration (Nonhuman)
DS Embryonated Ova (Stool) Rhabditiform larva (Stool)
IS Filariform Larva (Soil) – L3 Filariform Larva
Src. of Infection Soil-transmitted helminth (STH) STD
Morphology Meromyarian (2-5 cells per dorsal/ventral half) Meromyarian
FACULATATIVE
Loves warm area = nonfeeding
Chemoreceptor Ampids ✔ ✔
Phasmids ✔ ✔
Attachment/Dental pattern Bite: intestinal mucosa Penetration in intestinal mucosa: Honeycomb intestinal mucosa
Parasitic Free living
Male Size 0.7mm
Posterior Refer to a specific parasite Not been reliably identified Ventrally curved tail
Spicules Copulatory spicules
Gubernaculum Layer Smaller: Microconspicous Conspicuous (w/o Cephalic alea)
Female Color Colorless, semi-transparent Colorless, semi-transparent
Covering Fine striated cuticle
Size 2.2 mm 1 mm
Type Parthogenetic Oviviparus
Anterior Slender tapering
Esophagus Long slender, 3mm Double bulb esophagus
Refer to a specific parasite
Buccal Cavity Short, 4 indistinct Lips
Posterior Short conical tail
Vulva 1/3 Length of the body
Intestine Continuous to subterminal anus Straight cylindrical tube
Uterus 1 Uteris, single file of 8-12segmented 2 Horn Uterus [Embryonated
ova [50-58 μm] eggs]
Rhabditiform Buccal Cavity
(Feeding [Free-living]
stage) -225 μm
>Open buccal -Elongated
cavity Esophagus
>HK: more -Pyriform
attenuated posterior bulb
-Short buccal
cavity

Long buccal cavity [Image from CDC/PHIL]

 Genital
Primordium

Smaller Larger
Filariform
(Non-feeding stage)
>(MOT) Closed buccal cavity

Sheathed 550μm
Pointed posterior Nonsheathed
Barbed posterior
Embroynated Ova Image by Tai Soon Yong Thin shelled ova of Strongyloides stercoralis. Measuring 50µm by 30µm, 
> Single thin walled hyaline cell they are smaller than Hookworm eggs.  (SOURCE: CDC)
wall
> Blastomere (6~8)

Pathology Pneumonitis/Wakana disease Cochin China Diarrhea/Vietnam Diarrhea

Ground itch, Coolie itch, Mazza larva, Dev itch Autoinfection

HW anemia Hookwrom dermatitis

Hypoalbuminema
Pneumonitis/Wakana disease

Microcytic Hyperchromic Anemia of IDA Ground itch, Coolie itch, Mazza larva, Dew itch

Lung Heart Migration

3 Life Cycle of S. stercoralis

1. Direct
2. Indirect
3. Autoinfection

Dx Harada Mori Culture Method Harada Mori Culture Method

DFS Stoll/Beaver Technique

Kato technique Baerman Culture Technique

Kato-Katz Duodenal aspirate (Beale’s String Test/Entero String Test)

Conc. Tech
=ZnSO4/Brine CT
=Centrifugal floatation
=FECT
Tx Abendazole Abendazole
Mebendazole Thiabendazole
Prevention 1. Sanitary disposal of human feces 4. Treatment of infected individuals
(HK & S. stercoralis) 2. Wearing of shoes, slippers and boots 5. Mass chemotheraphy when prevalence is greater than 50%
3. Health education on personal, family and community hygiene 6. Protection of susceptible individuals by improving household
income and diet to prevent malnutrition
>Human Ancylostoma duodenale Necator americanus
CN Old World Hookworm New World Hookworm
MOT Ingestion/Skin penetration
Src. of Infection STH STH
Morphology Color Grayish white Grayish white
Cylindrical, Fusiform Cylindrical, Fusiform
Head Not pointed, curved Pointed
Mouth Thistle shape Funnel shape
Esophagus No gap between esophagus & intestines With gap
Body Curvature C-shape S-shaped
Dental Pattern Adult Ancylostoma duodenale worm. Anterior end with mouth parts visible. Adult Necator americanus worm. Anterior end with mouth parts visible. Courtesy
Courtesy of Patrick W Hickey, MD. of Patrick W Hickey, MD.

2 pair true ventral teeth, 1 pair median teeth Semi-lunar Cutting plates (Ventral & Dorsal)
inconspicuous Conspicuous buccal spear

Posterior Not pointed tail Pointed tail

Inconspicuous transverse striation Conspicuous transverse striation
Male
Size 8-11mm 5-9mm
Bursa Bell shaped Fan shaped
Spicule Straight, plain, bristle like Barbed
Digits Tripartite Bipartite
Female Straight pointy 9-11mm
Embryonated Ova 25,000-30,000 eggs/day 9,000 eggs/day
>Nonhuman Ancylostoma caninum Ancylostoma braziliense
CN Dog hookworm Cat Hookworm
FH Dog Dogs/Cat
Morphology Smallest HW
Attachment/Dental pattern

3 pair Ventral teeth 1 pair median teeth

Male

10mm
5mm
Bursa: Flare with long slender rays
Bursa: Round with short shubby rays
 Female 40mm

9mm
Pathology CLM: Cutaneous Larva Migrans/Creeping eruption in human

↑Eosinophilia
Penetration of stratum granulosum