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Stenotrophomonas Maltophilia: A Case Study on Its Role in Intra-Abdominal Abscesses

Stenotrophomonas maltophilia, often found in aqueous hospital settings, is gradually gaining attention as a pathogen contributing to nosocomial infections, specifically in immune-compromised patients. Routinely, this gram-negative bacterium is more likely to occur in cases of pneumonia and catheter-induced bloodstream infections. However, instances of Stenotrophomonas maltophilia related intra-abdominal abscesses are relatively obscure.

A recently reported unique instance follows a 75-year-old man diagnosed with diabetes and polymyositis who developed a fever 17 days after a total gastrectomy for gastric cancer. A hypodense solid mass confirmed as an intra-abdominal abscess was identified following an abdominal CT. The cultures for both blood and abscess drainage conclusively pointed only towards S. maltophilia. A combination treatment of abscess drainage and intravenous trimethoprim-sulfamethoxazole’s administration resulted in total recovery, with the patient not experiencing any recurrences.

This case brings up a significant point – the need to factor in S. maltophilia as a potential pathogen in patients displaying atypical post-surgical abdominal infections. Physicians should bear in mind the potential of S. maltophilia in causing intra-abdominal abscesses associated with Surgical Site Infections (SSI), in addition to Enterobacteriaceae, which is a principal causative pathogen of SSI. Greater insight can be gained into the etiology, epidemiology, and risk factors for SSI arising from S. maltophilia through further studies.

Considering the case of this patient who was on a low prednisolone dose for managing polymyositis while recovering from a solid tumor surgery, the risk factors for intra-abdominal abscesses due to S. maltophilia are indistinct. While S. maltophilia hospital-acquired infections appear to be increasing across the spectrum, its manifestation as a common cause of peritonitis is noteworthy, chiefly among patients undergoing peritoneal dialysis.


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