Strongyloid Hyperinfection in a Patient with Immunocompromised Chronic Kidney Disease

Strongyloid hyperinfection is seen in immunocompromised individuals with underlying lung disease. The use of immunosuppressive drugs is an important risk factor. We report a case of IgA nephropathy with crescent, started on glucocorticoid and mycophenolate mofetil. He presented with bilateral lung opacities with breathlessness. As the breathlessness was not improving, despite adequate ultrafiltration, bronchoscopy was done. Bronchoalveolar lavage fluid examination showed the presence of strongyloid larvae, which was later demonstrated in stool also. He responded to antihelminthic treatment with disappearance of larvae from stool but later developed secondary bacterial infections.