Strongyloidiasis is an emerging parasitic infection with intriguing epidemiology, presentation, and clinical management. We report a case of hyperinfection syndrome complicated by E. coli bacteremia and meningitis with one of the isolates showing a unique resistance pattern recently being recognized. This report describes the aspect of invasive bacterial infections in strongyloidiasis and highlights the unique susceptibility pattern of the E. coli isolate and the extreme caution required during the antibiotic therapy.