Answer to Case 812

Answer to the Parasite Case of the Week 812: Adult hookworms, male and female.

As noted by Idzi Potters and Florida Fan, it's a bit hard to make out the mouth parts from the first photo. However, by focusing up and down on the actual clinical specimen, we were able to confirm that there are 2 pairs of teeth present, consistent with Ancylostoma duodenale. The second image shows the end of the female worm, whereas Idzi notes that the third "gives a nice view of the bursa copulatrix - a specialized organ found in male hookworms, used for sensing and grasping during copulation." The spicules at the end of the male do not appear to be fused, which supports the identification of A. duodenale.

Florida Fan noted that "The images may be sufficient for treatment but for academic purposes they pose a challenge. Would a stool parasitology culture help to identify the species involved?" This is a great question. If eggs are present in the stool, they could be hatched using the Harada Mori or similar culture method, and this would allow them to develop into L1 and eventually L3 larvae. There are some subtle differences between the L3 larvae of the different hookworm species, so it might be possible to differentiate them from the L3 stage alone. However, I'm not sure I would be able to accurately differentiate them. Unfortunately, this is where the life cycle stops for stool culture; we can't rear the larvae into adults, since this requires entry into a suitable host. Thank you for bringing up this option, Florida Fan!