Background: Strongyloidiasis is a rare but persistent parasitic disease especially in the immigrant population and elderly patients from the Appalachian. Complicated strongyloidiasis (hyperinfection and dissemination) can cause multiorgan failure and death.
Case Report: We describe an unusual case of strongyloides hyperinfection in an elderly patient who did not have any history of exposure in endemic regions outside of the United States. Her clinical presentation was characterized by gastrointestinal symptoms.
Conclusions: Clinicians need to have a high index of suspicion for this infection, particularly in patients with skin, gastrointestinal and respiratory symptoms, and in patients with some kind of immunosuppressive condition.

Keywords: issemination, Hyperinfection, Immunosuppression, parasite, strongyloidiasis