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Mokaddas EM et al. – Hyperinfection with S. stercoralis is a rare but preventable complication of immunosuppressive therapy. A high index of suspicion is required for the diagnosis of this infection. Persistent examination of sputum, bronchial washings and upper intestinal aspirates should be done as part of surveillance following cadaveric renal transplantation. Adult respiratory distress syndrome is indeed a red flag in patients who are on steroids, not on cyclosporine and receiving a kidney from donors in endemic countries of S. stercoralis.


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