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# Hookworms Necator americanus is the most common species of hookworm found in the southeastern United States. Hookworm larvae may be swallowed directly or penetrate the skin, often the feet of children going barefoot, and migrate to the lungs where they are coughed up and swallowed and carried to...

# Hookworms Necator americanus is the most common species of hookworm found in the southeastern United States. Hookworm larvae may be swallowed directly or penetrate the skin, often the feet of children going barefoot, and migrate to the lungs where they are coughed up and swallowed and carried to the small intestines where they attach themselves to the walls to suck blood and multiply. Severe infection can result in hypochromic, microcytic anemia along with hypoproteinemia and malnutrition. Infection with hookworms can result in dyspnea, cardiomegaly, and arrhythmias and can be fatal in infants. Infected children may have restricted growth and mental development, which may be irreversible. Diagnosis is with serial stool specimens. The following are symptoms of hookworms: * **Initial symptoms**: Itching and rash at the site of infection. * **Later symptoms**: * Abdominal pain. * Diarrhea. * Anorexia. * Weight loss. * Anemia. **Treatment includes**: * Albendazole (Albenza®) 400 mg once OR * Mebendazole (Vermox®) 100 mg twice daily for 3 days or 500 mg once OR * Pyrantel pamoate (Pin-Rid®) 11 mg/kg to maximum 1 g for 3 days. * Iron supplements may be necessary as well. **Note**: Stools must be rechecked 1 week after treatment so that repeat treatment can be done if needed. # Scalp Ringworm and Ringworm ## Tinea Capitis (Scalp Ringworm) Tinea capitis is a fungal infection of the scalp that usually affects children ages 1-10. It is spread through the sharing of combs, brushes, or caps. Symptoms are circumscribed areas of hair loss with fine scaling and superficial pustules with mild itching. Treatment options are: * Griseofulvin orally 8-12 weeks * Selenium sulfide shampoo 2-3 times weekly, leaving shampoo on scalp for 10 minutes before rinsing ## Tinea Corporis (Ringworm) Tinea corporis is a fungal infection of the skin of the trunk, although it can occur on the face or other parts of the body. It affects both children and teenagers. It is spread by direct contact. Symptoms are one or multiple circular patches that may be scaly and erythematous with slightly raised borders. Treatment options are: * Selenium sulfide shampoo wash of area before applying medication * Topical antifungal (clotrimazole, miconazole, tolnaftate, naftifine, terbinafine) 2 times daily for 4 weeks