• Warm/temperate regions including southeast US, tropics/subtropics including Asia/Southeast Asia
  • Larvae enter thru feet/skin if walk barefoot in soil w/infected feces→ enter skin, where they can cause itching→ travel to lung→ penetrate alveoli and travel up trachea→ cough and then swallowed→ travel to and live in small intestine


  • Most carry life-long w/o any sx
  • Non-compromised hosts can have vague sx including cough, epigastic pain, weakness, watery diarrhea, constipation
  • Can cause life threatening hyper-infxn syndrome w/systemic symptoms if compromised from glucocorticoids, malignancy, HTLV-1 or organ transplant

Physical Exam Findings

  • Sometimes serpiginous red erruption from migrating larva under skin