Hookworm infections are widely prevalent in tropical and subtropical areas, especially in low income regions. In the body, hookworms parasitize the proximal small intestine, leading to chronic intestinal hemorrhage and iron deficiency anemia. Occasionally, hookworms can cause overt gastrointestinal bleeding, but this is often ignored in heavily burdened individuals from endemic infectious areas. A total of 424 patients with overt obscure gastrointestinal bleeding were diagnosed by numerous blood tests or stool examinations as well as esophagogastroduodenoscopy, colonoscopy, capsule endoscopy or double-balloon enteroscopy. All of the patients lived in hookworm endemic areas and were not screened for hookworm infection using sensitive tests before the final diagnosis. The patients recovered after albendazole treatment, blood transfusion, and iron replacement, and none of the patients experienced recurrent bleeding in the follow-up. All the 31 patients were diagnosed with hookworm infections without other concomitant bleeding lesions, a rate of 7.3% (31/424). Seventeen out of 227 patients were diagnosed with hookworm infections in the capsule endoscopy (CE), and 14 out of 197 patients were diagnosed with hookworm infections in the double balloon enteroscopy (DBE). Hookworm infections can cause overt gastrointestinal bleeding and should be screened in patients with overt obscure gastrointestinal bleeding (OGIB) in endemic infectious areas with sensitive methods. Specifically, the examination of stool specimens is clinically warranted for most patients, and the proper examination for stool eggs relies on staff’s communication.
Citations
Citations to this article as recorded by
Hookworm as an overlooked cause of overt gastrointestinal bleeding: A case report Dibya Jyoti Sharma, Aritra Banerjee, Dibyalochan Praharaj, Deepak K. Pandey, Suman Sarkar Tropical Doctor.2026; 56(1): 169. CrossRef
Combined morphological and molecular approaches to the clinical diagnosis of Necator americanus infection: a case report Xianshu Liu, Ailian Sun, Xingxing Zheng, Meng Xia, Yan Liu, Shuaiqin Huang, Xiang Wu Journal of Medical Case Reports.2025;[Epub] CrossRef
Hookworm: a challenge diagnosis of occult gastrointestinal bleeding A C Garcia, M Francisco, H Coelho, S Bragança, F Pereira Correia, M L Figueiredo, G Alexandrino, J C Branco, D Horta, M Alexandra Endoscopy.2025; 57(S 02): S415. CrossRef
Soil-Transmitted Helminth Infection and Macronutrient Intake among Stunted Toddlers in Panti Sub-district, Jember Ghaiska Najma Amnur, Yunita Armiyanti, Irawan Fajar Kusuma, Leersia Yusi Ratnawati, Wiwien Sugih Utami, Bagus Hermansyah Media Gizi Indonesia.2025; 20(1): 74. CrossRef
Hookworm infestation as a rare cause of melaena in tropics: A case report Narendra Pandit, Sameer Bhattarai, Dinesh Nalbo, Sanjay Yadav Tropical Doctor.2024; 54(2): 191. CrossRef
Chronic Hemorrhagic Anemia Caused by Hookworm Infection: A Case Report Baisheng Li, Shihong Chen, Xiangming Cui, Ming Dai, Wenying Meng, Qiong Wu, Huiming Sheng Acta Parasitologica.2023; 68(1): 288. CrossRef
Infecciones parasitarias del intestino P. Bourée EMC - Tratado de Medicina.2023; 27(4): 1. CrossRef
Endoscopic Diagnosis of Hookworm Disease in a Patient with Severe Iron Deficiency Anemia: A Case Report Shamil Tiremo, Mulugeta Shibeshi International Medical Case Reports Journal.2023; Volume 16: 841. CrossRef
Cumulative host energetic costs of soil-transmitted helminth infection Theresa E. Gildner, Tara J. Cepon-Robins, Samuel S. Urlacher Trends in Parasitology.2022; 38(8): 629. CrossRef
Human hookworms from Argentina: Differential diagnosis of Necator americanus and Ancylostoma duodenale in endemic populations from Buenos Aires and Misiones Andrea Servián, Silvia A. Repetto, María Lorena Zonta, Graciela T. Navone Revista Argentina de Microbiología.2022; 54(4): 268. CrossRef
Unusual Cause of Persistent Epistaxis with Severe Anemia in a Child Yilkal Zemene, Tadele Hailu, Josh Wiedermann, Seckin Ulualp Case Reports in Otolaryngology.2022; 2022: 1. CrossRef
Haematological abnormalities in children with sickle cell disease and non-severe malaria infection in western Kenya Paul Kosiyo, Walter Otieno, Jesse Gitaka, Elly O. Munde, Collins Ouma BMC Infectious Diseases.2021;[Epub] CrossRef
Perceptions of women, their husbands and healthcare providers about anemia in rural Pakistan: Findings from a qualitative exploratory study Sumera Aziz Ali, Anam Feroz, Zahid Abbasi, Savera Aziz Ali, Ahreen Allana, K. Michael Hambidge, Nancy F. Krebs, Jamie E. Westcott, Elizabeth M. McClure, Robert L. Goldenberg, Sarah Saleem, Frank T. Spradley PLOS ONE.2021; 16(4): e0249360. CrossRef
Evaluation of Hookworm Diagnosis Techniques from Patients in Debre Elias and Sanja Districts of the Amhara Region, Ethiopia Ayalew Jejaw Zeleke, Ayenew Addisu, Adane Derso, Yalewayker Tegegne, Meseret Birhanie, Tekeba Sisay, Mulugeta Aemero, José F. Silveira Journal of Parasitology Research.2021; 2021: 1. CrossRef
Identification and localization of hookworm platelet inhibitor in Ancylostoma ceylanicum Yue Huang, Asmaa M.I. Abuzeid, Yunqiu Liu, Long He, Qi Zhao, Xinxin Yan, Jianxiong Hang, Rongkun Ran, Yongxiang Sun, Xiu Li, Jumei Liu, Guoqing Li Infection, Genetics and Evolution.2020; 77: 104102. CrossRef
Effect of Ancylostoma ceylanicum hookworm platelet inhibitor on platelet adhesion and peripheral blood mononuclear cell proliferation Yue Huang, Asmaa M.I. Abuzeid, Tingting Zhuang, Shilan Zhu, Long He, Yunqiu Liu, Qi Zhao, Xiaoyu Chen, Guoqing Li Parasitology Research.2020; 119(6): 1777. CrossRef
Intestinal hookworm infestation causing chronic anaemia Marcello Cintolo, Lorenzo Dioscoridi, Mutaz Massad, Massimiliano Mutignani BMJ Case Reports.2019; 12(1): bcr-2018-228120. CrossRef
Ancylostoma duodenale as a cause of upper gastrointestinal bleeding: a case report Andrea Carlin Ronquillo, Lidia Benites Puelles, Luis Pampa Espinoza, Víctor Aguilar Sánchez, José Luis Pinto Valdivia The Brazilian Journal of Infectious Diseases.2019; 23(6): 471. CrossRef
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