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When the immune system of infected individuals is compromised, larvae may migrate from the gastrointestinal tract to other tissues, causing <jats:italic>S. stercoralis<\/jats:italic> hyperinfection syndrome, which has a reported mortality of 71%. In this case, we report a patient with <jats:italic>S. stercoralis<\/jats:italic> hyperinfection syndrome with central nervous system (CNS) involvement. An elderly South East Asian male tourist presented with pulmonary symptoms, fever and infiltrates on chest X-ray. He later developed symptoms of CNS infection. <jats:italic>S. stercoralis<\/jats:italic> larvae were found in a stool sample. Microbiological examination of cerebrospinal fluid revealed <jats:italic>S. stercoralis-<\/jats:italic>specific DNA. The patient was treated with oral and rectal ivermectin and albendazole. The condition was complicated by sepsis, bacteraemia and hypereosinophilia. Unfortunately, the patient eventually died from pulmonary oedema and insufficiency. This case highlights the global importance of <jats:italic>Strongyloides<\/jats:italic> CNS infection in endemic and non-endemic regions.<\/jats:p>","DOI":"10.1136\/bcr-2021-247032","type":"journal-article","created":{"date-parts":[[2022,9,22]],"date-time":"2022-09-22T11:44:23Z","timestamp":1663847063000},"page":"e247032","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["<i>Strongyloides stercoralis<\/i> hyperinfection syndrome with cerebral involvement"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0751-6918","authenticated-orcid":false,"given":"Andreas Arnholdt","family":"Pedersen","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Odense University Hospital, Odense, Denmark"},{"name":"Department of Pulmonary Research, Lillebaelt Hospital, Vejle, Denmark"},{"name":"Department of Regional Health Research, University of Southern Denmark, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6786-3551","authenticated-orcid":false,"given":"Gitte Nyvang","family":"Hartmeyer","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark"},{"name":"Research Unit of Clinical Microbiology, University of Southern Denmark Faculty of Health Sciences, Odense, Syddanmark, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1417-7048","authenticated-orcid":false,"given":"Christen Rune","family":"Stensvold","sequence":"additional","affiliation":[{"name":"Department of Bacteria, Parasites and Fungi, Infectious Disease Preparedness, Statens Serum Institut, Kobenhavn, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3543-1970","authenticated-orcid":false,"given":"Raquel","family":"Martin-Iguacel","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,9,22]]},"reference":[{"key":"2025082712570908000_15.9.e247032.1","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.idc.2018.10.006","article-title":"Strongyloidiasis: a neglected tropical disease","volume":"33","author":"Krolewiecki","year":"2019","journal-title":"Infect Dis Clin North Am"},{"key":"2025082712570908000_15.9.e247032.2","unstructured":"CDC . 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