Strongyloides infection in Hawaii: an imported case.

Tropical diseases may present anywhere in the world. A case of strongyloidiasis in Hawaii, identified by a characteristic manifestation, larva currens, is described. Strongyloides infection may persist long after leaving an endemic area through the mechanism of autoinfection and, especially under circumstances of immunosuppression, may become overwhelming (the hyperinfection syndrome), with a likelihood of being fatal. Each case of Strongyloides infection should be treated aggressively in order to prevent this dangerous outcome; in addition, the parasite should be eliminated before immunosuppressive therapy is begun.