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- W2978673049 abstract "Introduction: Stenotrophomonas maltophilia is a hydrophilic aerobic nonfermentative gram negative organism which was first isolated in 1943. Although it is not considered to be a highly virulent organism, it can cause serious infections especially in those in health care facilities who are immunosuppressed. The respiratory tract is the most common site of infection of the organism. However, there have been isolated reports of S. maltophilia in those patients with hepatobiliary malignancy complicated with biliary tract obstruction who have had instrumentation. Here we present a case of biliary sepsis with Stenotrophomonas. Case: A 68 year old female with medical history of cholangiocarcinoma presented due to refractory obstructive jaundice after endoscopic retrograde cholangiopancreatography (ERCP). The patient was initially diagnosed with Klatskin tumor 1.5 weeks prior to presentation status post ERCP with stenting 3 days prior to presentation. She subsequently developed severe, burning epigastric pain with nausea and vomiting and was found to have increasing total bilirubin levels with elevated lipase. She was treated for pancreatitis however, her total bilirubin continued to increase. She underwent repeat ERCP with removal of stent and finally had a percutaneous biliary drain placed. 2 days later she developed leukocytosis and fever of 102 degree fahrenheit with blood and bile cultures consistent with Strenotrophomonas maltophilia. She was treated with intravenous trimethoprim/sulfamethoxazole and ceftazidime. Her performance status continued to deteriorate and she opted for comfort care. Discussion: There have been at least five reports in literature of biliary sepsis secondary to S. maltophilia all of which occurred in patients with hepatobiliary malignancy who had undergone biliary tract instrumentation. S. maltophilia is naturally resistant to many classes of antibiotics and the reported mortality in patients who develop a clinically overt infection secondary to S. maltophilia varies from 14% to 69%. A differential of Stenotrophomonas in patients with hepatobiliary malignancy and hepatobiliary infections needs to be considered due to the increase emergence and high morbidity and mortality it is associated with." @default.
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- W2978673049 date "2016-10-01" @default.
- W2978673049 modified "2023-09-23" @default.
- W2978673049 title "The Emergence of Stenotrophomonas Species as an Important Cause of Mobility and Mortality Among Patients with Hepatobiliary Malignancy" @default.
- W2978673049 doi "https://doi.org/10.14309/00000434-201610001-01218" @default.
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