Strongyloides stercoralis hyperinfection in a renal allograft recipient

A patient who had received a renal allograft required intensive immunosuppression for a severe rejection episode. Four months after the graft he died of septicaemia and respiratory failure caused indirectly by a Strongyloides stercoralis hyperinfection. Patients from endemic areas who are to undergo a renal transplant should be screened for the parasite before receiving immunosuppressive therapy. Should this infection occur after transplantation, early diagnosis and treatment with thiabendazole is essential to prevent the high mortality rate associated with Strongyloides hyperinfection.