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Xanthomonas maltophilia infection presenting as erythematous nodules
Abstract:
Xanthomonas (Pseudomonas) maltophilia is increasingly being recognized as an opportunistic pathogen in hospitalized and debilitated patients. We describe X. maltophilia cellulitis in a neutropenic patient undergoing consolidation chemotherapy for acute lymphocytic leukemia. The patient had multiple, erythematous, nonulcerated nodules on the lower extremities. A biopsy specimen showed numerous gram-negative bacilli in the dermis and subcutis, without evidence of vasculitis. Tissue culture and subsequent blood cultures grew X. maltophilia. The cutaneous nodules and positive blood cultures resolved after treatment with intravenous ciprofloxacin and trimethoprim-sulfamethoxazole.
Insights
Xanthomonas maltophilia can cause cellulitis in immunocompromised patients. This case report details successful treatment of X. maltophilia cellulitis and bacteremia in a leukemia patient using antibiotics.
Area of Science:
- Infectious Diseases
- Dermatology
- Hematology
Background:
- Xanthomonas maltophilia (now known as Stenotrophomonas maltophilia) is an emerging opportunistic pathogen.
- Hospitalized and immunocompromised patients are particularly susceptible to X. maltophilia infections.
Observation:
- A neutropenic patient with acute lymphocytic leukemia developed erythematous nodules on the lower extremities during chemotherapy.
- Skin biopsy revealed gram-negative bacilli in the dermis and subcutis, with no signs of vasculitis.
Findings:
- Cultures of the biopsy specimen and blood confirmed X. maltophilia infection.
- The patient's cutaneous nodules and bacteremia resolved with intravenous ciprofloxacin and trimethoprim-sulfamethoxazole.
Implications:
- This case highlights X. maltophilia as a cause of cellulitis in neutropenic patients.
- Effective antibiotic regimens, including ciprofloxacin and trimethoprim-sulfamethoxazole, can successfully treat X. maltophilia infections.