Stenotrophomonas Necrotizing Tonsilitis in a Pediatric Patient: A Rare Presentation With Upper Airway Obstruction

Area of Science:

• Medical microbiology
• Infectious diseases
• Pediatric critical care

Background:

• Stenotrophomonas maltophilia (S. maltophilia) exhibits intrinsic antibiotic resistance, complicating treatment of opportunistic infections.
• S. maltophilia infections can be severe and life-threatening, particularly in vulnerable populations like immunocompromised individuals and hospitalized patients.
• High mortality rates necessitate prompt and effective therapeutic strategies.

Observation:

• A rare case of necrotizing tonsillitis and retropharyngeal abscess causing upper airway obstruction in an eight-month-old infant is presented.
• Intraoperative tissue cultures confirmed the presence of the highly virulent gram-negative bacillus, S. maltophilia.
• The infant was previously healthy, highlighting the potential for severe opportunistic infections even in non-immunocompromised individuals.

Findings:

• The case details the successful medical and surgical management of a severe S. maltophilia infection.
• The infant experienced a complete recovery following the intervention.
• This case underscores the importance of timely diagnosis and treatment for S. maltophilia infections.

Implications:

• This report emphasizes the critical role of multidisciplinary management in severe S. maltophilia infections.
• Early and appropriate antibiotic therapy, alongside surgical intervention, can be lifesaving.
• The case highlights the need for vigilance regarding S. maltophilia as a pathogen, even in seemingly healthy pediatric patients.