First report of survival in two patients with hematologic malignancy and Stenotrophomonas maltophilia hemorrhagic pneumonia treated with trimethoprim-sulfamethoxazole-based combination antibiotic therapy |
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| Institution: | 1. Infectious Diseases, Internal Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia;2. Critical Care Medicine, Hospital Pablo Tobón Uribe, Medellín, Colombia;3. Internal Medicine, Universidad de Antioquia, Medellín, Colombia;4. Infectious Diseases, Internal Medicine, Hospital Pablo Tobón Uribe, Medellín, Colombia;1. Departamento de Enfermedades Infecciosas, Hospital de Infectología, Centro Médico Nacional “La Raza”, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;2. Departamento de Microbiología, Biomedicina y Biotecnología Molecular, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, IPN, Mexico City, Mexico;3. Centro de Simulación Médica, Facultad Mexicana de Medicina, Universidad La Salle, Mexico City, Mexico;4. Laboratorio Central de Epidemiología, División de Laboratorios de Vigilancia e Investigación Epidemiológica, CMN “La Raza”, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;5. Unidad de Investigación en Enfermedades Infecciosas y Parasitarias, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;6. Departamento de Patología Clínica, Banco Central de Sangre, CMN “La Raza”, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;7. Laboratorio de Urgencias, Hospital de Infectología, Instituto Mexicano del Seguro Social, IMSS, Mexico City, Mexico;8. Center for HIV and Hepatogastroenterology, Duesseldorf, Germany;1. Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, Tokyo, Japan;2. Department of Emergency and Critical Care Center, Tokyo Metropolitan Bokutoh General Hospital, Tokyo, Japan;3. Hibiya Clinic, Tokyo, Japan;4. Department of Infectious Diseases, Tokyo Metropolitan Health and Hospitals Corporation Ebara Hospital, Tokyo, Japan;1. Division of Infection Control, Chiba University Hospital, 1-8-1 Inohana Chuo-ku, Chiba, 260-8677, Japan;2. Division of Pharmacy, Chiba University Hospital, 1-8-1 Inohana Chuo-Ku, Chiba, 260-8677, Japan;3. Department of Clinical Laboratory, Chiba University Hospital, 1-8-1 Inohana Chuo-Ku, Chiba, 260-8677, Japan;4. Biostatistics Section, Clinical Research Center, Chiba University Hospital, 1-8-1 Inohana Chuo-Ku, Chiba, 260-8677, Japan;1. Japan Physicians Association, Influenza Study Group, Tokyo, Japan;2. Ricderca Clinica Co., Fukuoka, Japan;3. Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan;1. Department of General Internal Medicine, Iizuka Hospital, 3-83 Yoshio-machi, Iizuka, Fukuoka, 820-8505, Japan;2. Department of Infectious Diseases, Iizuka Hospital, 3-83 Yoshio-machi, Iizuka, Fukuoka, 820-8505, Japan;3. Department of Bacteriology I, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan;4. Department of Orthopedics, Iizuka Hospital, 3-83 Yoshio-machi, Iizuka, Fukuoka, 820-8505, Japan |
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| Abstract: | Stenotrophomonas maltophilia has become a common cause of opportunistic infections in immunocompromised hosts and critical care patients. The most common disease manifestations are pneumonia and bacteremia, with a mortality ranging from 9% to 60.5% depending of the type of infection and host related underlying risk factors. Patients with hematological malignancies may develop a hemorrhagic pneumonia with a rapidly progressive and universally fatal disease course, despite appropriate treatment with trimethoprim/sulfamethoxazole or combination therapy. We report the first two patients with hematologic malignancies and hemorrhagic pneumonia due to S. maltophilia with successful treatment outcomes after early institution of combination therapy with TMP/SMX, polymyxin, and/or moxifloxacin. |
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| Keywords: | Trimethoprim-sulfamethoxazole Hemorrhagic pneumonia Combination therapy |
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