Stenotrophomonas maltophilia Endocarditis of Prosthetic Mitral Valve

Abstract

We present a 78-year-old woman with prosthetic valve endocarditis due to Stenotrophomonas maltophilia (S. maltophilia) 3 years after mitral valve replacement. Administration of sulfamethoxazole-trimethoprim was effective; however, it was discontinued because of side effects, which led to failure of antibiotic therapy. Complications of multiple cerebral infarction and paravalvular abscess developed. Although the prosthetic valve was removed 50 days after admission, she died 4 months after surgery. S. maltophilia has been increasingly being considered as a serious nosocomial pathogen. S. maltophilia endocarditis is rare; however, it should be recognized as a possible life-threatening disease in patients with prosthetic valve.

Stenotrophomonas maltophilia: an Emerging Global Opportunistic Pathogen

“…The variety of infections associated with S. maltophilia is shown in Table 1. Infections associated with S. maltophilia include (most commonly) respiratory tract infections (pneumonia [115,310] and acute exacerbations of chronic obstructive pulmonary disease [COPD] [101,247]); bacteremia (182,187,236); biliary sepsis (261); infections of the bones and joints, urinary tract, and soft tissues (33,191,297,343); endophthalmitis (4); eye infections (keratitis, scleritis, and dacryocystitis [202,224,370]); endocarditis (19,135,171,237,326); and meningitis (243,284). S. maltophilia is a significant pathogen in cancer patients, particularly those with obstructive lung cancer.…”

Replacement of the Native Mitral Valve Due to Endocarditis Caused by Stenotrophomonas Maltophilia

“…However, when the literature is examined carefully, it is observed that endocarditis caused by this bacterium is extremely rare [1] and especially includes a certain group of patients. This particular group of patients includes those with aortic or mitral prosthetic valve replacement and those with immune deficiency for any reason [2,3,5] . SM-caused endocarditis of native mitral valve is quite rare in the literature.…”

“…Stenotrophomonas maltophilia (SM) is a gram-negative bacillus that is increasingly associated with serious nosocomial infections, especially in immunocompromised patients; however, the occurrence of endocarditis due to this organism is rare [1] . Reports of SM-caused endocarditis usually are related to either aortic valve prosthesis [2] or mitral valve prosthesis [3] , or to patients who have a history of invasive procedures, such as pacemaker implantations [4] , or a history of accompanying immunosuppressive disease [5] . However, SM reporting as cause of endocarditis in the native mitral valve is extremely rare.…”

Intraabdominal abscess caused by Stenotrophomonas maltophilia : A case report

“…Although S. maltophilia is considered a pathogen with low virulence, it has been increasingly reported as a nosocomial pathogen responsible for serious infectious complications in immunocompromised hosts. S. maltophilia may cause a variety of infections, such as pneumonia, bacteremia, urinary tract infection, ocular infection, skin or soft tissue infection, endocarditis, peritonitis, cholecystitis, and meningitis [7] , [8] , but reports on organ/space SSI due to this organism have been few. Moreover, intraabdominal abscesses as a manifestation of SSI due to this organism is relative rare.…”