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Case 1. a Representative four-cell stage egg obtained from feces sample (55.9 x 36.6 mum). b A single filariform larva (750 x 25.0 mum), one of many recovered in Harada-Mori culture of feces. c Anterior of an adult Ancylostoma ceylanicum, showing prominent sets of outer (asterisk) and small inner (number sign) teeth on a cutting plate in the buccal cavity. d Posterior of an adult male Ancylostoma ceylanicum, showing mediolateral (asterisk) and posterior-lateral (number sign) rays of the copulatory bursa of the running parallel
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Fig1
Because of intermittent abdominal pain and watery diarrhea, the patient visited Kyoto Prefectural University of Medicine, where hookworm eggs were detected in a feces sample prepared by formalin-ethyl ether sedimentation (Fig. 1a) along with an increased number of peripheral eosinophils (3.0 x 103/muL), while neither pathogenic protozoa nor bacteria were identified in fecal samples or culture. Filariform larvae of hookworms were found in a Harada-Mori culture (Fig. 1b). Eleven adult worms, five males and six females, were expelled after treatment with a single dose (10 mg/kg) of pyrantel pamoate and identified as A. ceylanicum based on morphological characteristics, such as one set of prominent outer and one set of much smaller inner teeth on a cutting plate in the mouthpart (Fig. 1c) and parallel mediolateral and posterior-lateral rays of the copulatory bursa in the males (Fig. 1d).
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Case 3. a Small nematode (arrow) in jejunum shown by capsule endoscopy. b Worm sucking blood with head hooked into intestinal mucosa (arrow) shown by double-balloon enteroscopy. c One each of female (upper) and male (lower) adult worms obtained in feces after pyrantel pamoate treatment
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Fig2
Capsule endoscopy findings led us to suspect small nematodes in the jejunum (Fig. 2a). Double-balloon enteroscopy confirmed the presence of worms, including one with its head hooked into the intestinal mucosa and sucking blood (Fig. 2b). Figure 2c shows one each of the female and male adult worms.
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