Strongyloidiasis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Strongyloidiasis?
An infectious disease doctor, a doctor who treats infections from germs and parasites, usually treats strongyloidiasis. A parasite is a living thing that lives on or inside another living thing. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is strongyloidiasis?
Strongyloidiasis is an infection with the roundworm Strongyloides stercoralis. A parasite is a living thing that lives on or inside another living thing. Strongyloides is a roundworm parasite. This roundworm is fairly common in warm, moist areas.
The infection is uncommon in the United States, but it does occur in the southeastern US. Most cases in North America are brought by travelers who have visited or lived in South America or Africa. Most people infected with Strongyloides have no symptoms and may not know they are infected.
Symptoms
Most of the time, there are no symptoms. If there are symptoms, they may include:
- Pain in the upper belly.
- Cough.
- Diarrhea.
- Rash, or red hive-like areas near the anus.
- Vomiting, weight loss, or fever.
Some people get a severe type called hyperinfection syndrome. In it, there are many worms and they multiply more quickly than normal. Severe infections often have a poor outcome, especially in people with a weakened immune system.
Causes and who gets it
People catch the infection when their skin comes in contact with soil that is contaminated with the worms. Young roundworms, called larvae, move through the skin into the bloodstream and then to the lungs. They move up to the throat and are swallowed. In the small intestine, they attach to the intestinal wall and later produce eggs. Unlike other worms, the larvae can re-enter the body through the skin around the anus, which allows an infection to grow.
Travel to tropical regions raises your risk. So does living in rural areas or warm, wet climates, living or working in agricultural settings, or living in long-term care facilities. The severe type can occur in people with a weakened immune system. This includes people who have had an organ or blood-product transplant. It also includes people with HIV/AIDS and those who take steroid medicine or immune-suppressing medicines.
How doctors diagnose it
Doctors may test a stool sample for the worm. Stool tests can miss the worm, so more than one stool sample may be needed. Blood tests can also be done. They include a count of eosinophils, a type of white blood cell. Duodenal aspiration is uncommon. It removes a small amount of tissue from the first part of the small intestine.
Treatment
The goal of treatment is to eliminate the worms with anti-worm medicines, such as ivermectin or albendazole. Some people need to take these medicines for as little as 1 to 2 days. If the infection has made you severely ill, you might take them for several weeks.
Sometimes people with no symptoms are treated. This includes people who take medicines that suppress the immune system. Examples are people who are going to have, or have had, a transplant. With proper treatment, the worms can be killed and full recovery is expected. Sometimes treatment needs to be repeated.
When to see a doctor
See a healthcare provider if you have symptoms of strongyloidiasis. This matters most for people with weakened immune systems. They can become severely ill or die from strongyloidiasis if it is not treated. Call 911 or go to the emergency room if you have trouble breathing, severe belly pain, or fainting. Also go if you cough up or vomit blood, or have severe or ongoing vomiting or diarrhea.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can review your symptoms and travel history, arrange tests, and refer you to an infectious disease doctor.
Common questions
Does strongyloidiasis always cause symptoms?
No. Most people infected with Strongyloides do not have any symptoms.
Can strongyloidiasis be prevented?
The best way to prevent Strongyloides infection is to wear shoes when you are walking on soil. It also helps to avoid contact with fecal matter or sewage and to clean up after dogs. Use improved sanitation facilities if available.
Can strongyloidiasis spread from person to person?
Yes, but only in rare cases. It can spread through organ transplants and in places such as long-term care facilities and daycare centers.
Is strongyloidiasis serious?
It can be, mostly for people with weakened immune systems. Severe infections often have a poor outcome in these people. With proper treatment, the worms can be killed and full recovery is expected.
Sources
- MedlinePlus - Strongyloidiasis
- Centers for Disease Control and Prevention - About Strongyloides
- Centers for Disease Control and Prevention - Clinical Overview of Strongyloides
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
