It’s a tale reminiscent of vampire sagas like True Blood and Twilight. Doctors at Sir Ganga Ram Hospital (SGRH) say they have cured a 14-year-old boy, whose 22 litres of blood was gulped down over the last two years by hookworms hiding in his small intestine.
Rahul Kumar (name changed) was down with acute anemia and had to undergo 55 units (22 litres) of blood transfusion over the two years. As a result, he suffered major weight loss and stunted growth.
Rahul hails from Haldwani in Uttarakhand where doctors could not detect the reasons for his blood loss. He was later referred to Delhi for treatment.
This unique case has now been published in the latest issue of the Journal of Infectious Diseases and Therapy. The findings suggest that hookworm manifestation if not diagnosed timely can not only lead to their multiplication but also significant blood loss and complications.
“A young boy of 14 years was referred to SGRH a few months ago with two episodes of passage of blood in stools. The child was suffering from iron deficiency anaemia for the last two years. He had received 50 units (22 litres) of blood transfusions and this is really an unusual case. His diagnosis could not be established even after repeated tests. His haemoglobin was low at 5.86,” Dr Anil Arora , chairperson of the department of gastroenterology at SGRH, told Mail Today.
Hookworms are parasites that live off other living things. They affect a person’s lungs and small intestine. Humans contract hookworms through roundworm eggs and larvae found in dirt contaminated by faeces.
Doctors performed dedicated abdominal tests including EGD (an endoscopy test), colonoscopy and radiographic studies of intestines; the results were normal.
“In view of the child’s obscure (unknown origin) gastrointestinal bleeding, we conducted capsule endoscopy. The results shocked us. We could see multiple hookworms buried in small intestine and were seen actively sucking blood with dancing movements,” said Dr Arora, adding that the sucked blood could be seen in the cavities of the hookworms, giving them a tint of red.
The white hookworms that had not yet sucked blood were seen lying quietly in the small bowel, he said.
Capsule endoscopy is a procedure that uses a tiny wireless camera to take pictures of a person’s digestive tract. A capsule endoscopy camera sits inside a vitamin-size capsule that the patient swallows.
The capsule costs about RS 50,000 which can provide at least 70,000 images (two images per second) as soon as the capsule dissolves inside the stomach.
Experts say that conventionally hookworm infestation is found commonly in Asian population. The worms enter the body through contaminated drinking water, unhygienic food, dirty hands and walking bare foot on the soil.
There are no specific symptoms or signs of hookworm infection, but they give rise to a combination of intestinal inflammation and progressive iron-deficiency anaemia and protein deficiency.
Coughing, chest pain, wheezing, and fever will sometimes result from severe infection. Following the treatment, Rahul is doing well and has also gone back to school. Doctors informed that his haemoglobin has improved and he is being monitored regularly.