It is known that Strongyloides stercoralis can induce intestinal strongyloidiasis, hyperinfection syndrome or disseminated strongyloidiasis. Paralytic ileus and associated bacterial infections may be seen as complications of hyperinfection syndrome or disseminated disease. This report discusses a case of hyperinfection syndrome in a patient who was receiving chronic immunosuppressive treatment for rheumatoid arthritis. In spite of treatment for hyperinfection syndrome with oral albendazole and rectal ivermectin, the patient’s condition worsened and he died of progressive respiratory failure. The limitations of treatment for hyperinfection syndrome will briefly be discussed.