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Strongyloidiasis A037

Last amended 
4 July 2019
Current RMA Instruments
Reasonable Hypothesis SOP
63 of 2019
Balance of Probabilities SOP
64 of 2019
Changes from previous Instruments

SOP Bulletin 209

ICD Coding
  • ICD-9-CM Codes: 127.2
  • ICD-10-AM Codes: B78
Brief description

Strongyloidiasis is a parasitic disease caused by an intestinal roundworm. It is endemic in some tropical and subtropical countries. It is often subclinical or only mildly symptomatic, causing nonspecific gastrointestinal, skin or lung symptoms.  Infection occurs via skin contact with soil or other material contaminated by human faeces.  Low grade infection can persist for decades if untreated.

Confirming the diagnosis  

Diagnosis is usually established by microscopic identification of larvae in stool or from blood testing.  False negative results are common and repeat testing may be required.

The relevant medical specialist is an infectious diseases physician.

Additional diagnoses covered by SOP
  • Strongyloides hyperinfection syndrome (in an immunosuppressed person)

Clinical onset

Symptoms may be mild and may have been present for years before coming to clinical attention.  Establishing clinical onset may be difficult, but the SOP factors that relate to infection acquired from skin contact allow that exposure can have been any time before onset.

Clinical worsening

Worsening may be evidenced by an increase in the level of existing symptoms or extension of disease to involve other organ systems (liver, heart, central nervous system, and endocrine glands).  A hyperinfection syndrome with organ dysfunction and even septic shock can develop in the presence of immunosuppression.  Effective drug therapy is available to treat the condition.