Liver Abscess Caused by Stenotrophomonas maltophilia : Report of a Case

Abstract

We report the case of a melioidosis-like abscess of the liver caused by Stenotrophomonas (Xanthomonas) maltophilia infection in a Chinese man living in Hungary. Although this appears to be the first documentation of a liver abscess of this origin in a nonimmunocompromised patient, our case report demonstrates that this common facultative pathogen can also cause liver abscess and sepsis. After repeated negative blood cultures, histological examinations of liver biopsies suggested the possibility of chronic melioidosis, but the microbiological examination performed directly on the same specimen identified a Stenotrophomonas maltophilia infection. Surgical drainage was performed and sulphamethoxazole/trimethoprim therapy was commenced, after which the patient recovered fully. The facultative pathogen S. maltophilia, which most often causes nosocomial infections, may cause severe sepsis and liver abscess. We wish to draw attention to the fact that the antibiotic sensitivity of S. maltophilia is not necessarily the same in vivo and in vitro. This can create difficulties in both diagnosis and treatment.

Stenotrophomonas maltophilia: the significance and role as a nosocomial pathogen

“…55 Another study demonstrated good synergy with TC/CL and aztreonam and the role for trovafloxacin either with TC/CL or TMP/SMX. 45 However, there are extremely limited data on the use of combinations in clinical practice. Significant lower mortality among patients receiving combination therapy when compared with monotherapy has been reported from uncontrolled studies.…”

Antifolate Activity of Epigallocatechin Gallate against Stenotrophomonas maltophilia

“…The major risk factors for S. maltophilia infection include long-term hospitalization, previous antimicrobial therapy, fungal infections, catheterization, and mechanical ventilation. S. maltophilia infection can cause bacteremia, endocarditis, pneumonia, mastoiditis, peritonitis, meningitis, or infections of the eyes, bones, joints, urinary tract, soft tissues, and wounds (4,7,10,19,21,29,30,39). The management of infections caused by S. maltophilia is particularly difficult because of its inherent resistance to many currently available broad-spectrum antibiotics (5,10,11,20,22,34).…”

A májsebészet története a Szegedi Tudományegyetem Sebészeti Klinikáján

“…Az osztályon kezdetben számos beteget operáltunk májtályog miatt, később néhány kivételtől eltekintve kizárólagosan ultrahang-, ritkábban CT-vezérelt drenázst alkalmaztunk. A kedvező tapasztalatok alapján, ugyancsak a Radiológiai Klinikával együttműködve, bevezettük az ultrahangvezérelt percutan epehólyagdrenázst a rossz állapotú akut cholecystitisben szenvedő betegek kezelésére [11][12][13][14].…”