Treatment refractory Stenotrophomonas maltophilia bacteraemia and pneumonia in a COVID-19-positive patient

BMJ Case Rep. 2021 Jun 17;14(6):e242670. doi: 10.1136/bcr-2021-242670.

Abstract

Stenotrophomonas maltophilia is an opportunistic pathogen that most often infects patients requiring mechanical ventilation, indwelling central venous catheters and broad-spectrum antibiotics. The reported incidence of S. maltophilia infection has increased over the past two decades, and many of its risk factors are commonly seen in patients with severe COVID-19 infection. Our case regards a patient with severe COVID-19 pneumonia, who subsequently developed disseminated S. maltophilia infection, refractory to first-line treatment and optimal medical management. This case highlights the high index of suspicion required for diagnosing secondary complications in patients with COVID-19 infection and highlights the difficulty in treating disseminated S. maltophilia infection in critically ill patients.

Keywords: adult intensive care; infections; nosocomial infections; pneumonia (infectious disease); unwanted effects / adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • COVID-19*
  • Gram-Negative Bacterial Infections* / complications
  • Gram-Negative Bacterial Infections* / diagnosis
  • Gram-Negative Bacterial Infections* / drug therapy
  • Humans
  • Pneumonia* / drug therapy
  • SARS-CoV-2
  • Stenotrophomonas maltophilia* / immunology

Substances

  • Anti-Bacterial Agents

Supplementary concepts

  • Stenotrophomonas maltophilia bacteremia