Abstract
Background: Stenotrophomonas maltophilia (S. Maltophilia) is a gram-negative bacillus presumed to be a commensal and rarely causes opportunistic infections in immunocompromised individuals. Since it is resistant to most of the commonly prescribed antibiotics, it carries a high mortality. S. maltophilia infective endocarditis is extremely rare and only 43 cases have been reported worldwide till date.
Case Report: Our patient was a 45 years old male, known case of diabetes mellitus, Rheumatic heart disease (RHD) with previous aortic valve replacement, who had 2 episodes of S. maltophilia bacteremia and first episode being diagnosed as possible infective endocarditis being subsequently managed medically. However in the second episode of bacteremia diagnosis of infective endocarditis was confirmed and patient required prosthetic valve replacement.
Conclusion: This case is being presented to emphasize the possibility of infective endocarditis due to S. maltophilia and the clinicians should be aware of its potential significance in appropriate clinical setting and diagnosis should be considered early to prevent mortality.
Keywords: Stenotrophomonas Maltophilia, Infective Endocarditis.
References
- Palleroni NJ, Bradbury JF. Stenotroph-omonas, a new bacterial genus for Xanthomonas maltophilia (Hugh 1980) Swings et al. 1983. Int J Syst Bacteriol. 1993;43:606-09.
- Marshall WF, Keating MR, Anhalt JP, Steckelberg JM. Xanthomonas malto-philia: an emerging nosocomial pathogen. Mayo Clin Proc. 1989;64:1097-04.
- Bayle S, Rovery C, Sbragia D, Brouqui P. Stenotrophomonas maltophilia prosthetic valve endocarditis: a case report. J Med Case Reports. 2008;2:174.
- Suhani S, Patnaik A, Barik R, Nemani L. Infective endocarditis caused by Stenotrophomonas maltophilia: A report of two cases and review of literature. Indian Heart J. 2016;68:S267-S270.
- Crum NF, Utz GC, Wallace MR. Stenotro-phomonas maltophilia endocarditis. Scand J Infect Dis. 2002;34:925-27.
- Meimoun P, Mainardi JL, Berrebi A, et al. Stenotrophomonas maltophilia endocarditis following mitral valve prosthesis implantation. Report of a case. Arch Mal Coeur Vaiss. 1999;92:1389-92.
- Munter RG, Yinnon AM, Schlesinger Y, Hershko C. Infective endocarditis due to Stenotrophomonas (Xanthomonas) maltophilia. Eur J Clin Microbiol Infect Dis. 1998;17:353–56.
- Khan IA, Mehta NJ. Stenotrophomonas maltophilia endocarditis: a systematic review. Angiology. 2002;53:49–55.
- Carrillo-Córdova JR, Amezcua-Guerra LM. Autoimmunity as a possible predisposing factor for Stenotrophomonas maltophilia endocarditis. Arch Cardiol Mex. 2012;82:204–07.
- Sattler CA, Mason EO Jr, Kaplan SL. Nonrespiratory Stenotrophomonas maltophilia infection at a children's hospital. Clin Infect Dis. 2000;31:1321-30.
- Aoun M, Van der Auwera P, Devleeshouwer C, et al. Bacteraemia caused by non-aeruginosa Pseudomonas species in a cancer centre. J Hosp Infect. 1992;22:307-16.
- Kim JH, Kim SW, Kang HR, et al. Two episodes of Stenotrophomonas maltophilia endocarditis of prosthetic mitral valve: report of a case and review of the literature. J Korean Med Sci. 2002;17:263-65.
- Vartivarian S, Anaissie E, Bodey G, Sprigg H, Rolston K. A changing pattern of susceptibility of Xanthomonas maltophilia to antimicrobial agents: implication for therapy. Antimicrob Agents Chemother. 1994;38:624-27.
Corresponding Author
Darshit Shah
Department of Internal Medicine
Sir Ganga Ram Institute of Postgraduate Medical Education and Research