• Larvae penetrates skin

  • Autoinfection: complete life-cycle in human (larvae hatch in intestine, penetrate intestinal mucosa and migrate to other organs e.g. lung)

  • Infection may persist lifelong

Clinical features

  • May be asymptomatic

  • Larva currens

  • Loffler's

  • GI upset: diarrhoea, pain, nausea, anaemia

Hyperinfection syndrome (in immunosuppressed, or even small dose of corticosteroids [caution re COVID-19] or other immunosupressive)

  • Pneumonia, meningitis, necrotising enterocolitis (severe diarrhoea, sepsis, death (60%)

  • Eosinophilia may be absent

  • Consider screening before giving steroids, treat with single dose of Ivermectin


  • Faecal OCP

  • Eosinophila (may be absent)

  • Larvae in sputum/tissues (hyperinfection)

  • Serology: can cross-react with others e.g. Hookworm?



  • Sanitation, shoes

  • MDA

  • Treat and treat before immunosuppression

Historical aspects

  • Observed in British soldiers who presented later in life with hyperinfection syndrome

Small intestine: all stages, adults, larvae, eggs