Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)
Tejaswi Kanderi, Isha Shrimanker, Qurat Mansoora, Kajol Shah, Anna Yumen, Saketram Komanduri
Department of Internal Medicine, University of Pittsburgh Medical Center (UPMC) Pinnacle, Harrisburg, PA, USA
Am J Case Rep 2020; 21:e921466
Available online: 2020-05-21
Stenotrophomonas maltophilia has the propensity to cause a plethora of opportunistic infections in humans owing to biofilm formation and antibiotic resistance. It is often seen as a co-organism along with Pseudomonas aeruginosa.
CASE REPORT: A 70-year-old woman with several co-morbidities presented reporting hypoglycemia and dyspnea. An imaging study of the chest was suggestive of deterioration of pneumonia, with increased opacities. Initial respiratory cultures were negative, while subsequent repeat cultures revealed the growth of Stenotrophomonas maltophilia susceptible to trimethoprim plus sulfamethoxazole and levofloxacin. The patient had a poor prognosis and eventually died despite appropriate measures.
CONCLUSIONS: A decline in the clinical status of a patient such as ours makes it hard to quickly diagnose this organism correctly. Physicians should thus be cautious of Stenotrophomonas maltophilia-induced infection and more emphasis should be placed on appropriate treatment due to the emerging risk of antibiotic resistance.
Keywords: Antibiotic Prophylaxis, Pneumonia, Stenotrophomonas maltophilia, Urinary Catheterization