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May 28, 1982

Diagnosis of Hookworm Disease

JAMA. 1982;247(20):2781. doi:10.1001/jama.1982.03320450019020

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To the Editor.—  This is in reply to the letter by Drs McIntyre and Keystone(1982;247:1565) regarding our previously published article (1981; 246:68).The egg count per gram of feces is a well-known method for estimating the intensity of worm infection, because it reflects the number of worms parasiting the host. In the reported case we did not have fecal egg counts because it is not a routine procedure at our hospital, but possibly it is not necessary because the jejunal mucous membrane was completely covered by hookworms (probably many thousands). The prothrombin, thrombin, and partial thromboplastin times, as well as the platelet count and fibrinogen level, were normal. There was no previous alcohol or other drug (including aspirin) intake in our patient. We agree that the patient might have had a mononucleosis-like illness, although the Paul Bunnel test result was negative, the liver biopsy specimen did not show cytomegalovirus inclusions,