Hookworm Infection in Infant: A Case Study and Review of Literature

Background: Hookworms are nematode parasites belonging to Ancylostomatidae helminth family that causes variety of clinical problems. They are often termed as soil transmitted helminths (STH) because human infection occurs by ingestion of eggs and /or skin contact with contaminated soil. Hookworm infection is common in tropical countries and transmission is influenced by climatic and socio-economic conditions. Hookworm infection in neonatal and infantile period are rarely reported. Here, we describe a case of two months old infant with hookworm infection and review the relevant literature.

Case Presentation: A two-month-old institution delivered male baby on exclusive breastfeeding with no significant ante natal or post natal history referred to our hospital with complains of black tarry stool since birth and progressive paleness of body requiring multiple packed cell transfusion. On investigation, child has severe anaemia with eosinophilia and positive stool for occult blood. Upper gastrointestinal endoscopy revealed hookworm in duodenum. The child was treated with oral mebendazole and discharged in good condition.

Discussion: Hookworm is a major public health problem in tropical and sub tropical countries. Most of the cases are asymptomatic and rarely detected. Hookworm infection can lead to growth retardation, failure to thrive, cognitive impairment and other manifestations also. Most of the cases are reported in older children and very few cases are reported in newborns and infants. Mechanism of transmission of infected larvae in such young infant in unclear. Transmission may occur vertically either through trans-placental route or by breastfeeding. Hookworm infection should be considered in differential diagnosis newborns and infants presented with unexplained weight loss, melena, anaemia with eosinophilia. The disease can be managed effectively through simple and easily available medications and adverse outcome can be prevented.

Conclusion: Very young infants residing in helminth endemic area with low socioeconomic status and presenting with severe anaemia with melena and/or failure to thrive, one should consider possibility of hookworm infection.