What Kind of Doctor Treats Parasites?

For most people, the first doctor to see about a possible parasite is a primary care provider, such as a family medicine doctor, an internal medicine doctor, a nurse practitioner or, for children, a pediatrician. If the problem is unusual, linked to travel abroad, or not clearing up, they can refer you to an infectious disease specialist, a travel medicine specialist or a gastroenterologist, depending on your symptoms.

The CDC's advice is that the specialist you see should match the symptoms you are having. This page explains what each kind of doctor does, which one fits which kind of worm, what happens at the visit, and when to get in-person care. It is general education, not medical advice.

Start with primary care

Parasitic diseases are diagnosed and treated every day in the United States, the CDC says, and many of them never need a specialist. A primary care provider (PCP) is the person MedlinePlus describes as the one you see first for checkups and health problems. That can be:

• A family medicine or internal medicine doctor (MD or DO)
• A nurse practitioner or physician assistant working in primary care
• A pediatrician, for a child
• An OB/GYN, for women who use one as their main doctor

A PCP can take your history, examine you, order a stool test for parasites or a blood count, and decide whether you need a prescription or a referral. Many health plans also require a referral from your PCP before they cover a specialist visit, so starting there can save time and money.

Which specialist does what

The CDC lists the kinds of doctors most often involved with parasites, and what each one focuses on:

• Infectious disease specialist. Illnesses caused by bacteria, viruses or parasites. Often the right referral for a rare or hard-to-diagnose parasite, a weakened immune system, or an infection that keeps coming back.
• Travel medicine specialist. Travel-related illnesses, both advice before a trip and testing after one. Some focus on tropical medicine and medical parasitology.
• Gastroenterologist. Diseases of the stomach and intestines. The CDC notes that when stool tests don't explain ongoing diarrhea or belly symptoms, a gastroenterologist may look inside the intestine with an endoscopy or colonoscopy.
• Dermatologist. Diseases of the skin, hair and nails, for example a rash or itching that may or may not be caused by a parasite.
• Internal medicine specialist. Adult illnesses, with broader training than a general practitioner.

Eye symptoms are a separate case. If a parasite could be affecting your eyes, an eye doctor (ophthalmologist) is usually part of the care.

Which doctor for which worm

The right first stop depends on the worm and how you might have caught it:

• Pinworm. The most common worm infection in the United States, according to the CDC, and it usually spreads at home, school or childcare. A primary care provider or pediatrician usually handles it, often with a pinworm tape test.
• Roundworm, whipworm and hookworm. Uncommon in the United States and mostly tied to living in, or traveling to, places where sanitation is poor. A PCP can order the stool test; a travel or infectious disease specialist may be involved if the history is complicated. See roundworm, whipworm and hookworm in humans.
• Strongyloides. Often has no symptoms and can be hard to find in stool. People who take steroids or other medicines that weaken the immune system face higher risk, so an infectious disease specialist is often involved. See strongyloidiasis symptoms and treatment.
• River blindness (onchocerciasis). Rare in the United States. A travel or tropical medicine specialist usually leads the workup, with an eye doctor if the eyes are affected. See onchocerciasis (river blindness).

Not every parasite is a worm. The CDC groups the parasites that affect people into three classes: one-celled protozoa (such as Giardia), worms (helminths), and parasites that live on the skin, such as lice and mites. Each class is handled differently, which is one more reason to get a diagnosis rather than guess.

What happens at the visit

The CDC says the tests a provider orders depend on your symptoms, your other health conditions and your travel history, and that diagnosis can be difficult, so more than one test is common. Depending on the case, that may include:

• A stool exam (ova and parasite test), often on several samples collected on different days
• A tape test for pinworm, done at home first thing in the morning
• Blood tests, which look for one specific parasite at a time; the CDC notes there is no single blood test that finds every parasite
• Endoscopy or colonoscopy, usually by a gastroenterologist, when stool exams don't find the cause
• Imaging, such as an x-ray or scan, for a few parasites that affect organs

It helps to bring a short written list: your symptoms and when they started, every country you have visited in the past few years, any time you walked barefoot on soil or swam in freshwater abroad, your medicines (especially steroids), and whether anyone you live with has similar symptoms.

Finding a specialist

The CDC is not a clinic and cannot refer patients to specific doctors or prescribe medicine. Its suggestions for finding someone experienced with parasites are:

• Ask your primary care doctor for a referral
• Contact your local, county or state health department, which may run a clinic
• Contact the nearest medical school teaching hospital for a specialist appointment
• Look up a member of a tropical medicine society, such as the American Society of Tropical Medicine and Hygiene, or the International Society of Travel Medicine

Not every doctor listed by a society sees patients, so check before you book.

Can telehealth help?

For some situations, yes. A telehealth provider can review your symptoms, history and any test results, and decide whether a prescription or an in-person visit is the better next step. Telehealth can't examine you, collect samples or perform procedures, so a provider may still send you for testing.

Get in-person care instead, and promptly, if you have a fever (especially after travel abroad), blood in your stool, severe or worsening belly pain, signs of dehydration, a spreading rash, eye pain or vision changes, a weakened immune system, or you are pregnant or breastfeeding.

Getting a prescription through Get It Prescribed

Get It Prescribed is a telehealth service for adults. A licensed provider reviews a written health assessment and decides whether mebendazole or ivermectin is appropriate for a labeled use. Mebendazole's labeled uses are pinworm, whipworm, roundworm and hookworm; ivermectin's are intestinal strongyloidiasis and onchocerciasis. Get It Prescribed does not treat protozoa, lice or other parasites. No prescription is guaranteed, and the provider may recommend testing or an in-person visit instead. How it works shows each step.

The medicines dispensed through Get It Prescribed are compounded preparations made by a licensed compounding pharmacy. They are not FDA-approved, the FDA has not reviewed them for safety, effectiveness or quality, and they are not generics of, or substitutes for, the brand-name products.

The cost is a one-time $50 provider consultation fee, plus $3.00 per ivermectin tablet or $3.50 per mebendazole capsule if a prescription is issued, with the quantity decided by the provider. The service is available in all 50 states and the District of Columbia; some states require a live phone or video visit.

This article is general education, not medical advice. It does not replace an evaluation by a licensed clinician who knows your history.

Related questions

Can a primary care doctor treat parasites?

Often, yes. The CDC says parasitic diseases are diagnosed and treated every day in the United States, and a primary care provider can order stool or blood tests and prescribe medicine when it is appropriate. They can refer you to a specialist if the case is unusual or doesn't clear up.

Should I see a gastroenterologist for parasites?

Usually not at the start. A gastroenterologist specializes in the stomach and intestines and is most often involved when stool tests don't explain ongoing digestive symptoms, since they can perform an endoscopy or colonoscopy. Your primary care provider can tell you whether a referral makes sense.

Do infectious disease doctors treat worms?

Yes. Infectious disease specialists treat illnesses caused by bacteria, viruses and parasites, including worms. They are most often involved for rare infections, infections after travel, or people with a weakened immune system.

What is a parasitologist?

Medical parasitology is the study of parasites that infect people. Doctors with this interest usually practice as infectious disease or tropical medicine specialists, and the American Society of Tropical Medicine and Hygiene lists physicians who consult in tropical medicine, medical parasitology and travelers' health.

Can I see a doctor online for worms?

For some situations. A telehealth provider can review your symptoms and history and decide whether a prescription is appropriate or whether you need testing or an in-person visit. Fever, blood in the stool, severe pain or eye symptoms need in-person care.

Sources

• CDC: What to Do When You Think You Have a Parasitic Disease — which kinds of doctors treat parasites, matching the specialist to symptoms, and how to find one.
• CDC: Diagnosis of Parasitic Diseases — stool exams, endoscopy and colonoscopy, blood tests and imaging.
• CDC: About Parasites — the three classes of parasites that cause disease in people.
• CDC: About Pinworm Infection — the most common worm infection in the United States and how it spreads.
• CDC: About Strongyloides — often no symptoms; higher risk with immune-weakening medicines.
• MedlinePlus: Types of health care providers — primary care providers and the specialties they refer to.
• MedlinePlus: Parasitic Diseases — consumer overview from the National Library of Medicine.
• American Society of Tropical Medicine and Hygiene: Clinical Consultants Directory — physicians who consult in tropical medicine, medical parasitology and travelers' health.
• DailyMed: mebendazole chewable tablet prescribing information — labeled uses: pinworm, whipworm, roundworm and hookworm.
• DailyMed: ivermectin tablet prescribing information — labeled uses: intestinal strongyloidiasis and onchocerciasis.
• FDA: Compounding and the FDA — Questions and Answers — what compounded preparations are and how they are regulated.