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Stenotrophomonas maltophilia Infection in a Patient with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD): A Colonizer or True Infection?

Challenging differential diagnosis

Olubunmi O. Oladunjoye, Adeolu O. Oladunjoye, Oreoluwa Oladiran, Anthony A. Donato

USA Department of Internal Medicine, Reading Hospital, Tower Health System, Reading, PA, USA

Am J Case Rep 2020; 21:e924577

DOI: 10.12659/AJCR.924577

Available online: 2020-05-08

Published: 2020-06-02


BACKGROUND: This article describes a finding of sputum culture positive for Stenotrophomonas maltophilia in an elderly woman with past medical history of chronic obstructive pulmonary disease (COPD) and hypertension, presenting with acute hypoxemic hypercapnic respiratory failure secondary to COPD exacerbation from bronchitis/bronchopneumonia.
CASE REPORT: Computed tomography (CT) of the chest showed secretions in the lower lobe bronchi and small scattered clustered nodules consistent with bronchitis/mild bronchopneumonia without evidence of pulmonary embolism. A sputum culture was positive for Stenotrophomonas maltophilia. She was treated with trimethoprim/sulfamethoxazole for 10 days. She recovered and was subsequently discharged from the hospital.
CONCLUSIONS: Stenotrophomonas maltophilia, previously known as a colonizer, is now being recognized as a true respiratory infection, especially in immunocompromised patients and those with chronic diseases like COPD presenting with signs and symptoms of infection. Therefore, early identification and prompt treatment of Stenotrophomonas maltophilia infection is important for a favorable outcome.

Keywords: Pulmonary Disease, Chronic Obstructive, Respiratory Tract Infections, Stenotrophomonas maltophilia



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