Opportunistic infections with Strongyloides stercoralis are rare in Western countries. However, individuals with cellular immunity defects may develop a disseminated infection. We report the case of a 78-year-old Italian male who developed progressive respiratory failure six weeks after initiation of corticosteroid therapy for temporal arteritis. Infective filariform Strongyloides stercoralis larvae, found in the sputum one day before death, clarified the complex clinical picture. It is advisable that before and during immunosuppressive treatments, the stools and body fluids of patients should be screened for parasites.