Hookworm infection in infants: a case report and review of literature.


Journal

Italian journal of pediatrics
ISSN: 1824-7288
Titre abrégé: Ital J Pediatr
Pays: England
ID NLM: 101510759

Informations de publication

Date de publication:
09 Feb 2021
Historique:
received: 30 10 2020
accepted: 02 02 2021
entrez: 10 2 2021
pubmed: 11 2 2021
medline: 25 2 2023
Statut: epublish

Résumé

Hookworm infections (Necator americanus, Ancylostoma duodenale) are common in rural areas of tropical and subtropical countries. Human acquisition results from direct percutaneous invasion of infective larvae from contaminated soil. Overall, almost 472 million people in developing rural countries are infected. According to simulation models, hookworm disease has a global financial impact of over US$100 billion a year. Hookworm infection in newborn or infancy is rare, and most of the cases reported in literature are from endemic countries. Here, we describe the case of an infant with an Ancylostoma duodenale infection and review the literature currently available on this topic. An Italian 2-month-old infant presented with vomit and weight loss. Her blood exams showed anemia and eosinophilia and stool analysis resulted positive for hookworms' eggs, identified as Ancylostoma duodenale with real time-PCR. Parasite research on parents' stools resulted negative, and since the mother travelled to Vietnam and Thailand during pregnancy, we assumed a transplacental transmission of the infection. The patient was treated successfully with oral Mebendazole and discharged in good conditions. Hookworm helminthiasis is a major cause of morbidity in children in the tropics and subtropics, but rare in developed countries. Despite most of the patients is usually asymptomatic, children are highly exposed to negative sequelae such as malnutrition, retarded growth and impaired cognitive development. In infants and newborns, the mechanism of infection remains unclear. Although infrequent, vertical transmission of larvae can occur through breastfeeding and transplacentally. Hookworm infection should be taken into account in children with abdominal symptoms and unexplained persistent eosinophilia. The treatment of infants infected by hookworm has potential benefit, but further studies are needed to define the best clinical management of these cases.

Sections du résumé

BACKGROUND BACKGROUND
Hookworm infections (Necator americanus, Ancylostoma duodenale) are common in rural areas of tropical and subtropical countries. Human acquisition results from direct percutaneous invasion of infective larvae from contaminated soil. Overall, almost 472 million people in developing rural countries are infected. According to simulation models, hookworm disease has a global financial impact of over US$100 billion a year. Hookworm infection in newborn or infancy is rare, and most of the cases reported in literature are from endemic countries. Here, we describe the case of an infant with an Ancylostoma duodenale infection and review the literature currently available on this topic.
CASE PRESENTATION METHODS
An Italian 2-month-old infant presented with vomit and weight loss. Her blood exams showed anemia and eosinophilia and stool analysis resulted positive for hookworms' eggs, identified as Ancylostoma duodenale with real time-PCR. Parasite research on parents' stools resulted negative, and since the mother travelled to Vietnam and Thailand during pregnancy, we assumed a transplacental transmission of the infection. The patient was treated successfully with oral Mebendazole and discharged in good conditions.
DISCUSSION CONCLUSIONS
Hookworm helminthiasis is a major cause of morbidity in children in the tropics and subtropics, but rare in developed countries. Despite most of the patients is usually asymptomatic, children are highly exposed to negative sequelae such as malnutrition, retarded growth and impaired cognitive development. In infants and newborns, the mechanism of infection remains unclear. Although infrequent, vertical transmission of larvae can occur through breastfeeding and transplacentally. Hookworm infection should be taken into account in children with abdominal symptoms and unexplained persistent eosinophilia. The treatment of infants infected by hookworm has potential benefit, but further studies are needed to define the best clinical management of these cases.

Identifiants

pubmed: 33563313
doi: 10.1186/s13052-021-00981-1
pii: 10.1186/s13052-021-00981-1
pmc: PMC7871578
doi:

Substances chimiques

Antinematodal Agents 0
Mebendazole 81G6I5V05I

Types de publication

Case Reports Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

26

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Auteurs

G Umbrello (G)

Università degli Studi di Milano, Milan, Italy. giulia.umbrello@unimi.it.

R Pinzani (R)

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

A Bandera (A)

Università degli Studi di Milano, Milan, Italy.
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

F Formenti (F)

Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Verona, Negrar, Italy.
Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.

G Zavarise (G)

Tropical Pediatric Unit, IRCCS Ospedale Sacro Cuore Don Calabria, Verona, Negrar, Italy.

M Arghittu (M)

Laboratory of Clinical Chemistry and Microbiology, ASST Melegnano and Martesana, Milan, Italy.

D Girelli (D)

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

A Maraschini (A)

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

A Muscatello (A)

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

P Marchisio (P)

Università degli Studi di Milano, Milan, Italy.
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

S Bosis (S)

Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

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