Strongyloidiasis
What is Strongyloidiasis?
Strongyloidiasis is an infection caused by a roundworm called Strongyloides stercoralis. This tiny parasite lives in soil and enters the body through the skin. It typically happens when someone walks barefoot on contaminated ground.
Once inside, the worm travels to the intestines and can live there for decades. Most people pick up this infection in tropical and subtropical regions. The parasite can reproduce inside the body, leading to a cycle of reinfection without new outside exposure.
In healthy people, the infection often causes mild symptoms or none at all. However, it becomes dangerous in people with weakened immune systems. The infection can spread throughout the body in a condition called hyperinfection syndrome. Early detection through blood testing helps prevent serious complications.
Symptoms
- Itchy skin rash where the parasite entered the body
- Stomach pain and bloating
- Diarrhea that comes and goes
- Nausea and loss of appetite
- Dry cough or wheezing
- Weight loss over time
- Red, raised tracks on the skin that move as the larvae migrate
Many people with strongyloidiasis have no symptoms for years or decades. The infection can hide quietly in the body until the immune system becomes weakened. Blood tests may show elevated eosinophils as the only sign of infection.
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Causes and risk factors
Strongyloidiasis occurs when the Strongyloides stercoralis roundworm penetrates the skin. The parasite lives in warm, moist soil contaminated with human waste. Walking barefoot in endemic areas is the most common way people get infected. The infection is most prevalent in rural parts of tropical and subtropical countries.
Risk factors include living in or traveling to areas where the parasite is common. Weakened immune systems from HIV, cancer treatment, or steroid medications increase the risk of severe infection. People with HTLV-I infection face particularly high risk of fatal complications. Organ transplant recipients need screening because immunosuppressive drugs can trigger hyperinfection syndrome. Agricultural workers and people who walk barefoot outdoors have higher exposure risk.
How it's diagnosed
Doctors diagnose strongyloidiasis using stool tests and blood work. The ova and parasites test looks for roundworm larvae in stool samples. Multiple stool samples may be needed because the parasite does not appear consistently. Blood tests can reveal elevated eosinophils, a type of white blood cell that rises in response to parasitic infections.
Rite Aid offers blood testing at Quest Diagnostics locations nationwide to check eosinophil levels and HTLV I/II antibodies. Testing for HTLV is important because this virus increases the risk of severe strongyloidiasis. Anyone who has lived in or traveled to endemic areas should consider testing, especially before starting immune-suppressing medications. Early detection prevents dangerous complications.
Treatment options
- Antiparasitic medication called ivermectin, typically for one to two days
- Repeated treatment courses for severe or chronic infections
- Alternative medication albendazole if ivermectin is not available
- Avoiding walking barefoot in areas where the parasite may live
- Regular follow-up testing to confirm the infection is gone
- Screening before starting immunosuppressive therapy
- Hospitalization for hyperinfection syndrome with IV medications
Concerned about Strongyloidiasis? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
Early signs include an itchy, red rash where the parasite entered the skin, usually on the feet. Some people develop stomach pain, diarrhea, or a dry cough within weeks of infection. Many people have no symptoms at all in the early stages. Elevated eosinophils on a blood test may be the only clue.
You get strongyloidiasis when the Strongyloides stercoralis roundworm penetrates your skin. This typically happens when walking barefoot on soil contaminated with human waste. The infection is common in tropical and subtropical regions with poor sanitation. The parasite cannot spread directly from person to person.
No, strongyloidiasis does not go away without treatment. The parasite can reproduce inside your body and maintain infection for decades. It will persist even without new exposure from outside. Medication is necessary to clear the infection.
Blood tests can show elevated eosinophils, a type of white blood cell that rises with parasitic infections. HTLV I/II antibody testing helps identify people at risk for severe complications. The ova and parasites test examines stool samples for roundworm larvae. Multiple tests may be needed for accurate diagnosis.
People with weakened immune systems face the highest risk. This includes those taking steroid medications, undergoing cancer treatment, or living with HIV. People with HTLV-I infection have particularly high risk of fatal complications. Organ transplant recipients also need careful screening before immunosuppressive therapy begins.
Doctors treat strongyloidiasis with an antiparasitic medication called ivermectin. Most people take it for one to two days. Severe infections may require multiple treatment courses. Albendazole is an alternative medication if ivermectin is unavailable.
Yes, untreated strongyloidiasis can cause chronic diarrhea, malnutrition, and weight loss. In people with weakened immune systems, it can spread throughout the body. This hyperinfection syndrome affects the lungs, brain, and other organs. It can be fatal without prompt treatment.
Without treatment, strongyloidiasis can last for decades or even a lifetime. The parasite reproduces inside the body and maintains infection indefinitely. With proper antiparasitic medication, most infections clear within weeks. Follow-up testing confirms the parasite is gone.
Yes, testing is recommended if you spent time in tropical or subtropical regions, especially rural areas. Testing is particularly important before starting medications that suppress the immune system. Blood tests can check eosinophil levels and screen for risk factors. Early detection prevents serious complications.
Wear shoes when walking on soil in areas where the parasite is common. Avoid direct skin contact with soil in tropical and subtropical regions. Improve sanitation to prevent soil contamination with human waste. If you have been exposed, get tested even without symptoms.