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Case Reports in Transplantation
Volume 2016 (2016), Article ID 1786265, 5 pages
Case Report

Strongyloides Hyperinfection Syndrome Combined with Cytomegalovirus Infection

1Division of Infectious Diseases, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia
2Department of Nephrology, Prince Sultan Military Medical City, Riyadh 11159, Saudi Arabia

Received 11 June 2016; Revised 14 August 2016; Accepted 28 August 2016

Academic Editor: Carl Classen

Copyright © 2016 Fatehi Elnour Elzein et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The mortality in Strongyloides hyperinfection syndrome (SHS) is alarmingly high. This is particularly common in bone marrow, renal, and other solid organ transplant (SOT) patients, where figures may reach up to 50–85%. Immunosuppressives, principally corticosteroids, are the primary triggering factor. In general, the clinical features of Strongyloides stercoralis hyperinfection are nonspecific; therefore, a high index of suspicion is required for early diagnosis and starting appropriate therapy. Although recurrent Gram-negative sepsis and meningitis have been previously reported, the combination of both cytomegalovirus (CMV) and strongyloidiasis had rarely been associated. We here describe a patient who survived SHS with recurrent Escherichia coli (E. coli) urosepsis and CMV infection.