Fast Five Quiz: Are You Prepared to Confront Parasitic Infections?

Michael Stuart Bronze, MD


June 29, 2017

In the past, treatment of pregnant or lactating women was discouraged because of concerns about potential teratogenicity. Currently, these persons are recognized as being at higher risk for more severe anemia; thus, treatment may be warranted after careful clinical consideration of the risks and benefits. The World Health Organization recommends deworming treatment (eg, albendazole, mebendazole, or pyrantel pamoate) during the second or third trimester for pregnant women with heavy hookworm infections.

For patients with cutaneous larva migrans who have minimal symptoms, specific anthelmintic treatment may be unnecessary.

Eosinophilic enteritis may mimic acute appendicitis or intestinal perforation. Some patients are diagnosed at the time of surgery for unexplained abdominal pain. However, treatment for eosinophilic enteritis is medical (ie, mebendazole administration) rather than surgical.

Antihelminthic drugs effective against hookworms include benzimidazoles (eg, albendazole, mebendazole) and pyrantel pamoate. Treatment regimens include:

  • Albendazole in a single 400-mg dose or daily for 3 days

  • Mebendazole 100 mg twice daily for 3 days (more effective than a single 500-mg dose)

  • Thiabendazole 15% cream applied topically to attack migrating larvae in cutaneous larva migrans

  • Pyrantel pamoate in several 11-mg/kg doses, usually over 3 days

For more on the treatment of hookworm disease, read here.


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