B76.0 Ancylostomiasis

Name of the Condition

• Ancylostomiasis

Summary

Ancylostomiasis is a parasitic infection caused by the hookworm Ancylostoma duodenale or Ancylostoma ceylanicum. The infection primarily affects the small intestine, where adult worms attach to the mucosa and feed on blood, leading to iron-deficiency anemia and protein loss. It is endemic in tropical and subtropical regions with poor sanitation and is transmitted through contact with contaminated soil.

Causes

The infection is caused by the larvae of Ancylostoma hookworms, which penetrate the skin, typically through barefoot contact with soil contaminated by human feces. Larvae migrate to the lungs, are coughed up and swallowed, and mature into adult worms in the small intestine. Adult worms attach to the intestinal wall, causing blood loss and nutritional deficiencies.

Risk Factors

• Exposure to soil contaminated with human feces, especially in areas with poor sanitation.
• Walking barefoot or with inadequate footwear in endemic regions.
• Living in or traveling to tropical or subtropical areas where hookworms are common.
• Poor socioeconomic conditions and limited access to clean water or hygiene facilities.
• Occupational or recreational activities involving direct contact with contaminated soil.

Symptoms

• Pruritic (itchy) rash at the site of larval penetration, often on the feet or ankles.
• Cough, wheezing, or shortness of breath during larval migration to the lungs.
• Abdominal pain, diarrhea, or nausea.
• Fatigue, weakness, or pallor due to anemia.
• In severe cases, protein loss leading to edema or growth retardation in children.

Diagnosis

Diagnosis is based on clinical presentation, exposure history, and laboratory tests. Stool microscopy may reveal hookworm eggs. Complete blood count (CBC) can show microcytic anemia or eosinophilia. In some cases, serologic tests or molecular assays may be used to confirm infection.

Treatment Options

Treatment typically involves anthelmintic medications, such as albendazole or mebendazole, to eliminate adult worms. Iron supplementation is often prescribed to address anemia. In severe cases, blood transfusions or nutritional support may be necessary. Follow-up stool tests may be performed to confirm eradication.

Prognosis and Follow-Up

With appropriate treatment, prognosis is generally good, and most patients recover fully. Follow-up may include monitoring for resolution of anemia or recurrence of symptoms. In endemic areas, reinfection is possible, and preventive measures are recommended.

Complications

• Severe anemia, particularly in children or malnourished individuals.
• Protein-losing enteropathy leading to edema or growth retardation.
• Intestinal obstruction or perforation in rare cases.
• Chronic fatigue or developmental delays in untreated cases.

Lifestyle & Prevention

• Wear protective footwear in endemic areas to avoid skin contact with contaminated soil.
• Improve sanitation, including proper disposal of human feces and avoiding use of untreated human waste as fertilizer.
• Treat infected individuals promptly to reduce environmental contamination.
• In high-risk regions, consider mass drug administration programs for prevention.

When to Seek Professional Help

Seek medical attention if you experience unexplained fatigue, pallor, abdominal pain, or a pruritic rash after potential exposure to contaminated soil. Prompt treatment is important to prevent complications, especially in children or immunocompromised individuals.

Tips for Medical Coders

When coding for ancylostomiasis, use ICD-10-CM code B76.0. Ensure documentation supports the diagnosis, including clinical findings (e.g., anemia, eosinophilia) and exposure history. Differentiate from other hookworm infections (e.g., Necator americanus) if specified, as coding may vary by organism. Verify that the code aligns with the provider’s clinical documentation and any associated manifestations.