Strongyloides infection in a cardiac transplant recipient: making a case for pretransplantation screening and treatment.

Solid organ transplantation has become the therapy of choice for various types of organ failure. Two major complications, infection and malignancy, result from the lifelong immunosuppression needed to maintain allograft function. Most commonly, posttransplantation infections result from reactivation of latent infections in the donor organ or the recipient; Strongyloides stercoralis is one example of an organism that can exist in an asymptomatic host. The risk of reactivating a latent infection is related to the degree of post-transplantation immune suppression, particularly suppression of cell-mediated immunity. We describe a case of fatal Strongyloides hyperinfection syndrome in a patient who had previously undergone orthotopic heart transplantation.