It was first called cochin china Diarrhea. Strongyloides eggs, laid by the female worm, hatch into uninfective rhabditiform larvae, which are usually passed in the stool, then molt again in soil to become infective 'filariform' larvae. This process normally takes 24 to 48 hours. The infective larvae gain access to a new host in a manner similar to that of the hookworm, in which the larvae burrow into bare skin that has come into contact with contaminated soil. Occasionally, the developmental process takes place entirely within the host, with both molts occurring within the digestive tract, before stool passage.
Most immunocompetent patients are relatively asymptomatic.
Overwhelming symptoms may develop in the immunocompromised individual. Clinical suspicion is required, as the telltale eosinophilia present in the normal host is lost in the hyperinfected patient. Larvae may be infective immediately upon passage from host. Infectious disease consultation for Strongyloides with immune compromise. Apparent plasma half-life is 16 hrs.