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Letters to the Editor removed. Antibacterials were ultimately narrowed to IV TMP-SMX to complete a total 21-day course. CASE 3A 12-year-old boy with complex history presented with ventriculoperitoneal shunt malfunction requiring removal and EVD placement. During the prolonged hospitalization, he required multiple EVD replacements. Following a failed removal and emergent replacement, he developed a fever. He was empirically started on meningitically dosed IV vancomycin and ceftriaxone. CSF cultures grew S. maltophilia; IV levofloxacin was added, and he underwent another EVD replacement. IV minocycline was added 4 days later given concerns that resistance could develop on monotherapy.While all 3 patients had good clinical outcomes, these cases present learning opportunities. In all patients, Stenotrophomonas was not initially considered on the differential. The Infectious Diseases Society of America Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis do not include Stenotrophomonas coverage in recommended empiric therapy; rather, they appropriately suggest an anti-Pseudomonal β-lactam and vancomycin. 3 However, it is important consider empiric therapy for this organism in the appropriate clinical setting. As with any biofilm-forming organism, removal of indwelling foreign material is an essential part of management. 3 By maintaining a high index of suspicion and pursing appropriate treatment when necessary, pediatric infectious disease providers can play an important role in optimizing outcomes following Stenotrophomonas infections.