Abstract

TAMAYO MENESES, Luis; YANIQUEZ ZUNAGUA, Ronald  and  PADILLA SOSA, Lilia. Anemia severa causada por Necator americanus: Reporte de un caso. Cuad. - Hosp. Clín. [online]. 2008, vol.53, n.1, pp.52-55. ISSN 1562-6776.

In temperate climate, yungas (intermediate zone between valley and tropical lowland), two blood sucking parasites are prevalent: Necator americanus and Ancylostoma duodenale, responsible for chronic anaemia in children that causes extremely low Hb levels sometimes considered as incompatible with life; only in rare cases acute bleeding occurs. We describe the case of a six months old child stemming from Coroico (Nor Yungas) initially with dysentery that becomes complicated by melaena and rectal bleeding originating severe hypovolaemia bordering on shock. After gammagraphy in order to exclude Meckel’s diverticle, the child was submitted to surgical exploration, where no source of bleeding could be found, therefore an explorative laparotomy was performed and later on an endoscopy, where the source of bleeding was identified in the duodenum as caused by the parasite Necator Americanus. With this diagnose, blood transfusions were administered to the child in order to stabilize the hypovolaemia and Mebendazol was given. The evolution was good, the bleeding stopped and feeding was well tolerated. Acute bleeding caused by hook worms is exceptional; therefore we present this case as a short reminder of the responsible mechanisms.

Keywords : Hypovolaemia; severe anaemia; melaena; rectal bleeding; Necator americanus.

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