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Stenotrophomonas maltophilia: an increasing problem in patients with acute leukaemia
1Department of Haematology, Southern General Hospital, Glasgow, Scotland, UK.
Abstract:
Stenotrophomonas maltophilia (previously Pseudomonas maltophilia and Xanthomonas maltophilia) is an increasing problem as an opportunistic pathogen in immunocompromised patients such as those with acute leukaemia. Infection is difficult to treat and eradicate due to its inherent and quickly acquired resistance to many antibiotics. Presentation with unusual cutaneous lesions is not uncommon and can present diagnostic difficulties. We present two cases which highlight the classical features of this infection in leukaemic patients, and discuss the need for early antibiotic treatment with regimens including cotrimoxazole, and the consideration of prompt central venous catheter removal.
Insights
Stenotrophomonas maltophilia infections are a growing concern in immunocompromised patients, particularly those with acute leukaemia. Early antibiotic treatment with cotrimoxazole and central venous catheter removal are crucial for managing these difficult-to-treat infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Oncology
Background:
- Stenotrophomonas maltophilia is an opportunistic pathogen increasingly implicated in infections among immunocompromised individuals, notably those with acute leukaemia.
- The pathogen exhibits significant intrinsic and acquired antibiotic resistance, complicating treatment and eradication strategies.
- Unusual cutaneous manifestations are common in S. maltophilia infections and can pose diagnostic challenges.
Observation:
- This report details two cases of S. maltophilia infection in leukaemic patients.
- The cases illustrate classical clinical presentations of this infection.
- Diagnostic difficulties associated with cutaneous lesions were noted.
Findings:
- S. maltophilia poses a significant challenge in immunocompromised patients, especially those with acute leukaemia.
- Infections are characterized by antibiotic resistance, making treatment difficult.
- Cutaneous lesions are a common and diagnostically challenging presentation.
Implications:
- Early and appropriate antibiotic therapy, including cotrimoxazole, is essential for effective management.
- Prompt removal of central venous catheters should be considered in cases of S. maltophilia infection.
- Increased awareness and diagnostic vigilance are necessary for timely intervention in at-risk patient populations.