A case of presumed person-to-person transmission of Strongyloides steracolis is described. The index case was immunocompromised following high dose glucocorticosteroid therapy for myelodysplasia, which resulted in reactivation of latent strongyloides infection with the hyperinfestation syndrome. Physicians unfamiliar with this disease should realize that a history of foreign travel is unnecessary to acquire this parasite, and that transmission to persons in close proximity to the index case does occur and warrants treatment.