Abstract
Human hookworm infection is caused by the nematodes Necator americanus, Ancylostoma duodenale, and Ancylostoma ceylanicum. Iron deficiency anemia is the hallmark of chronic, moderate-to-heavy-intensity infections, promoting a vicious poverty cycle. Overt severe and acute life-threatening lower gastrointestinal hemorrhage is an extremely rare manifestation of hookworm infection, as well as finding multiple nematodes attached to the colonic mucosae. This rare hookworm presentation with hematochezia from the colon in a patient living with human immunodeficiency virus highlights the importance of physicians' awareness of this neglected tropical disease responsible for high morbidity and burden in healthcare systems of endemic regions.