Lung hookworm disease

　　First, etiology

　　The hookworm eggs develop into infective filarial larvae through shedding, enter the human body through the skin and mucosa, and agricultural work is an important source of infection.

　　Second, pathogenesis

　　After the filarial larvae enter the human body through the skin or mucosa, they pass through the lymphatic or blood vessels to the lungs, and then penetrate the pulmonary capillaries into the alveoli, causing pinpoint hemorrhage, infiltration of inflammatory cells, and the pathological changes of the lungs are similar to those of lung ascaris. Severe infection can form pulmonary lobular consolidation and bronchitis.

　　1, Pica:Eating coal slag, wall skin, uncooked rice, etc., is often more serious than ascariasis.

　　2, Skin changes:The place where the filarial larvae enter the skin has a burning and itching sensation, and the facial skin has anemic spots, blisters, and other skin changes.

　　The hands and feet of patients contacting contaminated substances often have small bleeding points, papules, small blisters, very itchy, i.e., hookworm dermatitis, or low fever, sore throat, pain, dry cough, blood in sputum, even massive hemoptysis, some patients may have transient dyspnea, chest tightness, asthma-like发作 symptoms, physical examination may have scattered dry or wet rales, laboratory examination peripheral blood leukocytosis, even with leukemoid reaction, eosinophil count slightly to moderately increased, sputum examination may find filarial larvae, chest X-ray according to the severity of the disease may appear blurred or enlarged hilum shadows, increased pulmonary vessels, patchy or nodular shadows, and other changes, pulmonary X-ray manifestations usually disappear in half to 1 month.

　　Strengthen health education, promote the harmless treatment of feces, reform the methods of fertilization and tillage, and carry out regular general surveys and treatments in the epidemic area. This disease seriously affects the daily life of patients, so it should be actively prevented.

　　1, Peripheral blood:Examine peripheral blood leukocytosis, even with leukemoid reaction, eosinophil count slightly to moderately increased, sputum examination may find filarial larvae.

　　2, Chest X-ray:According to the severity of the disease, there may be changes such as blurred or enlarged hilum shadows, increased pulmonary vessels, and patchy or nodular shadows, and the X-ray manifestations of the lungs usually disappear in half to 1 month.

　　First, dietary therapy for pulmonary hookworm disease

　　1, Ginger juice eel drink: 100 grams of eel (deboned and shredded), 10 milliliters of ginger juice. Mix the eel with ginger juice, peanut oil, and a little salt, cook over rice until the water is almost dry, place the fish shreds on the rice and cover tightly, simmer over low heat for 15 minutes until cooked and served. Suitable for anemia patients.

　　2, Codonopsis pilosula and red date tea: 20 grams of Codonopsis pilosula, 10 red dates, boil the water to make tea. Suitable for anemia patients.

　　3, 15 grams of Chinese prune. Add 250 milliliters of water, boil to extract 60 milliliters of liquid, take on an empty stomach before breakfast, the second decoction before lunch, one dose per day, 5 days as one course.

　　4, 15-20 grams of broussonetia papyrifera seeds, and 15-20 kernels of Brucea javanica. For children under 10 years old, calculate 1 kernel per year, and for those over 10 years old, take 15-20 kernels each time. Dosage: Take orally 3 times a day, for 3-6 days.

　　5. Fresh Portulaca oleracea 250 grams (dried product 150 grams), 50 milliliters of white vinegar. For children under 6 years old, the dose is halved. Method: Boil the medicine with 250 milliliters of water to 150 milliliters, take 1 dose in the morning and evening on an empty stomach. Take 50 milliliters of white vinegar with the medicine, 7 days as a course, with a 3-day interval between courses. (Source: 'Selected Prescriptions of Chinese Medicine for Children')

　　6. Yellow eel 150 grams, ginger juice, and a moderate amount of peanut oil. Method: Wash the eel clean, cut into segments, mix with ginger juice and peanut oil, and cook until the water is almost dry. Place the eel meat on the rice, simmer over low heat for 30 minutes before serving.

　　II. Foods that are good for the body in pulmonary hookworm disease

　　Diet should be hygienic, and food should be cooked before consumption.

　　III. Foods to avoid for pulmonary hookworm disease

　　1. Do not drink unboiled water.

　　2. Do not eat unclean salad.

　　I. Treatment

　　Scabies dermatitis, can be treated with 2% to 4% iodine alcohol, 15% thiabendazole (Thiabendazole) ointment or suspension plus 0.1% dexamethasone for local application.

　　Deworming treatment options include:

　　1. Albendazole (Intestinal Worm Clear):It selectively and irreversibly inhibits glucose uptake in intestinal nematodes, causing the exhaustion of endogenous glycogen in the worms and inhibiting fumarase to hinder ATP production, leading to worm death. The drug is well absorbed after oral administration, with a peak blood concentration reached within 2.5-3.0 hours, and a half-life of about 8.5 hours. The adult dose for deworming hookworms is 400mg per day, taken once a day for 3 consecutive days, with a deworming rate of 97%. The dose for children under 12 years old is halved. It is contraindicated in pregnant women and lactating women, and should be used with caution in patients with a history of epilepsy.

　　2. Levamisole:The antiparasitic activity of this product is twice that of tetramizole, selectively inhibiting the succinate dehydrogenase of the worm's muscle, causing paralysis of the worm and excretion with intestinal peristalsis. The adult dose for deworming hookworms is 100-200mg, taken once a day after a meal, for 2-3 consecutive days.

　　3. Oxibendazole:The adult dose is 10mg/kg (100mg per tablet), taken once a day on an empty stomach for 3 consecutive days, with an egg-yolk negative rate of 56% to 100%, few adverse reactions, mild in nature, and no treatment is required as they can disappear spontaneously.

　　II. Prognosis

　　Generally good.