Fatal Strongyloides hyperinfection syndrome in renal transplant recipients: a neglected cause of immunosuppression-related mortality.

Patient 1 was a 59-year-old male originally from Vietnam with end-stage renal disease secondary to IgA nephropathy, with hypertension and T2DM. He underwent cadaveric renal transplantation with basiliximab and methylprednisolone induction followed by maintenance tacrolimus, mycophenolate mofetil and tapering prednisolone. He was treated for CMV reactivation and developed an acneiform folliculitis during the post-transplant course which was otherwise uncomplicated. He presented three months later with abdominal pain, constipation and vomiting. On day 3 of admission he deteriorated rapidly, becoming clinically septic.