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Stenotrophomonas (Xanthomonas) maltophilia infection in necrotizing pancreatitis
K E Mönkemüller1, D E Morgan, T H Baron
1University of Alabama at Birmingham, USA.
Conclusion:
Although the therapy of infected pancreatic collections or organized pancreatic necrosis remains surgical, we have demonstrated that infected organized pancreatic necrosis can be treated endoscopically.
Background:
Stenotrophomonas (Xanthomonas) maltophilia has been increasingly recognized as a nosocomial pathogen associated with meningitis, pneumonia, conjunctivitis, soft tissue infections, endocarditis, and urinary tract infections. This organism is consistently resistant to imipenem, a drug commonly employed in patients with necrotizing pancreatitis to prevent local and systemic infections.
Methods And Results:
We report the first case of infected pancreatic necrosis by S. (X.) maltophilia. Our patient was treated successfully with endoscopic drainage of the pancreatic fluid collection and appropriate antibiogram-based antibiotic therapy. Endoscopic drainage has emerged as one of the treatment modalities for pancreatic fluid collections.
Insights
Infected pancreatic necrosis caused by Stenotrophomonas maltophilia can be successfully treated with endoscopic drainage and targeted antibiotics. This minimally invasive approach offers an alternative to surgery for this challenging infection.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Surgical Innovation
Background:
- Stenotrophomonas (Xanthomonas) maltophilia is an emerging nosocomial pathogen.
- This bacterium exhibits resistance to imipenem, a common antibiotic for necrotizing pancreatitis.
- Infected pancreatic necrosis poses significant treatment challenges.
Observation:
- A case of infected pancreatic necrosis caused by S. (X.) maltophilia is reported.
- The patient presented with a pancreatic fluid collection.
- S. (X.) maltophilia was identified as the causative agent.
Findings:
- Successful treatment was achieved through endoscopic drainage of the pancreatic fluid collection.
- Antibiotic therapy was guided by antibiogram results.
- Endoscopic drainage is a viable treatment option for pancreatic fluid collections.
Implications:
- This study demonstrates the efficacy of endoscopic intervention for infected pancreatic necrosis.
- It highlights a potential treatment strategy for infections caused by antibiotic-resistant organisms like S. (X.) maltophilia.
- Endoscopic drainage may reduce the need for invasive surgical procedures in select cases.