CONSIDERAÇõES SÔBRE A FASE LARVÁRIA DA INFECÇÃO ANCILOSTOMÓTICA. SÔBRE DOIS CASOS CLÍNICOS DE ANCILOSTOMÍASE AGUDA

Abstract

The A.A. report two cases presenting the clinicai features of an acute hookworm infection. The patients were well to do children, a boy 9 years old and a girl 10 years old. Both acquired the hookworm infection at sea-shore in S. Vicente (Praia Grande) and Guarujá near Santos, respectively. The symptoms showed by the patients were similar but those in the boy were more severe. Cutaneous itching, persistent and non productive cough and acute gastro-intestinal disturbances were observed at first. Abdominal pain was localized in the epigastrium or umbilical region and accompanied by anorexia, nausea, vomiting, diarrhea and loss of weight and strenght. The presence of blood was verified in the faeces of both patients. Low grade fever of transitory character was observed in one of them. An incorrect diagnosis of appendicitis was made in both patients and one of them was submitted to the appendicectomy. The hematological changes were important and distinctive. lntensive anaemia was observed and in a patient requiring repeated blood transfusion while was only moderate in the other. The white blood count showed characteristic hyperleucocytosis and very high eosinophilia in both patients. Hookworm eggs were found in the stool examination in both cases but in only one was possible to identify the worms eliminated after the anthelminthic. So we had the proof that one of the cases was a pure Ancylostoma duodenale infection. The clinicai improvement was obtained ouly after repeated anthelminthic treatment. The hematological alterations particularly the leucocytosis and eosinophilia werc persistent for a long time. After discussing the diagnosis possibilities presented by their cases; the A.A. emphazise the relative rarity of the acute hookworm infection and review briefly the literature. Then the A.A. discuss thc etiopathogencsis and symptomatology of the larva! stage of the hookworm infection.