HOOKWORM(Cacing tambang)

ETIOLOGY:• ANCYLOSTOMA DUODENALE

• NECATOR AMERICANUS•(Intestinal Helminthiasis)

N. americanus & A. duodenale

Intensitas NA RTGT RTGT ADRingan < 2.000 < 7.000

Sedang 2000-7000 7000 – 35.000

Berat > 7.000 > 35.000

Prepaten 7 mgg 6 mgg

RTGT 80 50-80

Live span 3-5 th 1-6 th

Isapan darah/hr.ekor 0,05 cc 0,15 cc

Cara infeksi Oral, enteral, perkutaneus, intest.otoinfeksi

Oral, perkutaneus,

Telur/induk.hari 6000-10.000 15.000-20.000

Habitat Duod + jejun Jej + ilem prox

Life cycle

Telur (200 rb/hr/induk)

Tinja

Tanah

Larva rabditiform

Larva filariform

Menembus kulit

Aliran darah Jantung kanan

Paru

Naik ke trakea

tertelan

esofagusdewasa

Menembus alveoli

Sal. Napas > besar

ETIOLOGY

• Ankylostoma :– A. duodenale– N. amerikanus

(pembunuh org Amerika)– A. ceylanicum – A. malayanum– A. braziliensis– A. caninum

PATHOGENESIS

- FILARIFORM LARVAY MAY CAUSE A RASH AT THE SITE WHERE THEY

PENETRATE THE SKIN.

- LARVAL MIGRATION IN THE LUNGS EVOKES AN INFLAMMATORY

RESPONSE, PETECHIAL HEMORRHAGE, AND EPITHELIAL CELL

PROLIFERATION

- ATTACHMENT OF WORMS BY THEIR BUCCAL CAVITY LEADS TO

MUCOSAL INJURY ANEMIA CARDIAC FAILURE

CLINICAL MANIFESTATIONS (1)

SYMPTOMS

- GROUND ITCH PRURITIC

- COUGH

- LOW GRADE FEVER

- ANOREXIA

- DIARRHEA

- VAGUE ABDOMINAL PAIN

- ULCER-LIKE EPIGASTRIC SYMPTOMS

TREATMENT (1)

A. GENERAL MEASURES

1. RE-TREATMENT AT 2 WEEKS INTERVALS

2. IF ANEMIA IS PRESENT

- ORAL FERROUS SULFATE

- DIET: HIGH PROTEIN & VITAMINS 3 MONTHS

B. SPESIFIC MEASURES:

- PYRANTEL PAMOATE, SINGLE DOSE, 10 MG/KGBW (MAX. 1 GR)

- MEBENDAZOLE: 2X 100 MG/DAYLY FOR 3 DAYS OR SINGLE DOSE

500 MG

- AL BENDAZOLE: ORALLY ONCE 400 MG, FOR 2-3 DAYS

- THIABENDAZOLE: CUTANEOUS LARVA MIGRANS; 15% OINTMENT

FOR 3 DAYS

- TETRACHLORETHYLENE, 0,1 MG/KGBW (MAX. 5 ML) TAKEN

WHEN FASTING IN CAPSULES. ALLOW FOOD 3 H LATER, REPEAT

AT 4-DAY

- BEPHENIUM HYDROXYNAPHTHOATE, 5 G TID 1 DAY.

TREATMENT (2)

PROGNOSISIF IT IS RECOGNIZED BEFORE COMPLICATION

APPEAR COMPLETE RECOVERY AFTER TEATMENT