AIDS: A case is described of a profoundly immunosuppressed Brazilian man with AIDS presenting with a cough, abdominal and groin pain, shortness of breath, and wheezing. Past history included Pneumocystis pneumonia, and asthma that had been managed with bronchodilators. The patient also had a history of poor compliance with TMP-SMX prophylaxis. Prior to making a confirmed diagnosis, he is treated with antibacterial agents, TMP-SMX, and steroids. After results of a bronchoscopy and sigmoid oscopy showed adult strongyloides worms, the patient was treated with thiabendazole. Despite aggressive treatment, the patient died after a few days. This case indicates the need to screen for endemic organisms that can be reactivated in the immunocompromised host.