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Stenotrophomonas maltophilia: an unusual cause of biliary sepsis
K A Papadakis1, S E Vartivarian, M E Vassilaki
1Department of Medical Specialties, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
Abstract:
We report three cases of cholangitis caused by Stenotrophomonas maltophilia and review two other cases reported in the literature. All five episodes occurred in patients with hepatobiliary malignancy complicated by biliary tract obstruction. All five episodes occurred in patients with hepatobiliary malignancy complicated by biliary tract obstruction. All patients had undergone biliary tract instrumentation. Before infection developed, four of the five patients had received therapy with antibiotics that do not have in vitro activity against this organism. Four patients responded to appropriate antibiotic therapy and biliary tract decompression, whereas the fifth patient, who had persistent biliary obstruction, did not respond to appropriate antibiotic therapy.
Insights
Stenotrophomonas maltophilia cholangitis is rare, often occurring in patients with hepatobiliary malignancy and biliary obstruction. Appropriate antibiotics and biliary decompression are key to successful treatment.
Area of Science:
- Hepatology
- Infectious Diseases
- Medical Microbiology
Background:
- Cholangitis is an infection of the biliary tract.
- Stenotrophomonas maltophilia is an opportunistic pathogen.
- Hepatobiliary malignancy and biliary obstruction are risk factors for cholangitis.