Microbiology
Hookworm. A roundworm. Ancylostoma duodenale and Necator americanus.
Epidemiologic Risks
Walking in human feces. Really. Eggs pass in the stool and you walk in the stool and they invade through your skin. Beats eating them. Barely.
Syndromes
Ground itch: an intense pruritus, erythema, and a vesicular, papular rash where the larva penetrated.
Iron deficiency anemia is the most common manifestation of bowel infestation, but malnutrition in all its forms.
Treatment
Albendazole 400 mg orally once.
Mebendazole 100 mg orally twice a day for 3 days or 500 mg orally once.
Pyrantel pamoate 11 mg/kg (up to a maximum of 1 g) orally daily for 3 days.
"The efficacy of single-dose oral albendazole, mebendazole, and pyrantel pamoate against hookworm infections was 72% (95% CI, 59%-81%; 742 patients), 15% (95% CI, 1%-27%; 853 patients), and 31% (95% CI, 19%-42%; 152 patients), respectively (PubMed)."
Notes
H.L. Menken, America's second greatest writer, in his wisdom, referred to the US South as the hookworm belt. I look forward to your abusive e-mail in reply.
Females lay 30,000 eggs per day and 18 to 54 million eggs during their lifetime.