Strongyloides stercoralis hyperinfection presenting as acute respiratory failure and Gram-negative sepsis in a patient with astrocytoma

In developing countries, Strongyloides stercoralis infection is a common cause of morbidity and mortality. Death from strongyloidosis can result from hyperinfection or disseminated disease. Infections due to S. stercoralis are unusual in Saudi Arabia and are usually diagnosed in immigrants from endemic areas. We report a case in which S. stercoralis was isolated from the sputum of a patient with Gram-negative sepsis and respiratory failure, and review the salient features of this disease. A high index of suspicion should be maintained by clinicians treating patients in endemic areas presenting with new-onset wheezing, acute respiratory distress and/or Gram-negative sepsis to prevent the serious complications of Strongyloides hyperinfection and dissemination. (C) 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.