A 5-year-old girl is brought to the office by her mother due to 2 weeks of anorexia, nausea, epigastric discomfort, and loose bowel movements. She has had no fever or bloody stools. The patient recently returned from rural Brazil, where she spent the summer with family. She had no gastrointestinal symptoms during the trip but developed intensely pruritic eruptions between the toes of her right foot. The skin rash spontaneously resolved within a few days and was attributed to insect bites from walking barefoot in the fields. The patient has no prior medical conditions, takes no medications, and has received all age-appropriate vaccinations. On physical examination, the abdomen is soft and nontender with normoactive bowel sounds. Stool microscopy reveals smooth, thin-walled eggs. If left untreated, this patient's condition can lead to which of the following complications?

Question

A 5-year-old girl is brought to the office by her mother due to 2 weeks of anorexia, nausea, epigastric discomfort, and loose bowel movements.  She has had no fever or bloody stools.  The patient recently returned from rural Brazil, where she spent the summer with family.  She had no gastrointestinal symptoms during the trip but developed intensely pruritic eruptions between the toes of her right foot.  The skin rash spontaneously resolved within a few days and was attributed to insect bites from walking barefoot in the fields.  The patient has no prior medical conditions, takes no medications, and has received all age-appropriate vaccinations.  On physical examination, the abdomen is soft and nontender with normoactive bowel sounds.  Stool microscopy reveals smooth, thin-walled eggs.  If left untreated, this patient's condition can lead to which of the following complications?

Quizplus · Accepted Answer

Eductional Objective: Hookworms are transmitted when human skin comes into contact with soil contaminated with human feces.  The larvae penetrate the skin, travel to the lungs, are coughed up, and then subsequently swallowed.  Adult hookworms live in the small intestine and feed on human blood.  Therefore, chronic iron deficiency anemia (microcytic anemia) is the greatest complication.

A 5-Year-Old Girl Is Brought to the Office by Her