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Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 24 September 2011, last major update September 2011
Copyright: (c) 2003-2011, PathologyOutlines.com, Inc.

Clinical features

● Endemic in Southeastern United States, South America, Southeast Asia and Sub-Saharan Africa
● Infection occurs when larvae in soil penetrate the skin and travel to the lung via the venous circulation; the worms then travel up the trachea to the oropharynx and are swallowed setting up infection in the small intestine
● Female worms in the small intestinal mucosa produce eggs asexually (parthenogenesis) that are passed to the soil where they hatch to continue cycle of infection
● Larvae hatched in the intestines may penetrate the colonic mucosa to travel to the lung to reinitiate infection (autoinfection)
● Disease usually affects the gastrointestinal tract
● In immunocompromised patients, severe disease with large burden of parasites may occur; patients may present with alveolar hemorrhage (Prim Care Respir J 2009;18:337)
● May predispose to invasive infections caused by enteric organisms (Am J Clin Pathol 2007;128:622)


Life cycle

Micro description

● In the lung, eosinphilic pneumonia with hemorrhage may occur
● Worms may be found in airways, alveoli and blood vessels

Micro images images

Small bowel infection

Cytology images

Bronchial wash

BAL fluid

Sputum specimen

Pap stain


End of Lung-nontumor > Infections > Strongyloides

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