Skip to main content
SpringerLink
Log in

Stenotrophomonas (Xanthomonas) maltophilia infection in necrotizing pancreatitis

  • Case Report
  • Published:
International Journal of Pancreatology Aims and scope Submit manuscript

Summary

Conclusion: Although the therapy of infected pancreatic collections or organized pancreatic necrosis remains surgical, we have demonstrated that infected organized pancreatic necrosis can be treated endoscopically.

Background:Stenotrophomonas (Xanthomonas) maltophilia has been increasingly recognized as a nosocomial pathogen associated with meningitis, pneumonia, conjunctivitis, soft tissue infections, endocarditis, and urinary tract infections. This organism is consistently resistant to imipenem, a drug commonly employed in patients with necrotizing pancreatitis to prevent local and systemic infections.

Methods and Results: We report the first case of infected pancreatic necrosis by S. (X.) maltophilia. Our patient was treated successfully with endoscopic drainage of the pancreatic fluid collection and appropriate antibiogram-based antibiotic therapy. Endoscopic drainage has emerged as one of the treatment modalities for pancreatic fluid collections.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Penzak SR, Abate BJ. Stenotrophomonas (Xanthomonas) maltophilia: a multidrug-resistant nosocomial pathogen. Pharmacotherapy 1997; 17: 293–301.

    PubMed  CAS  Google Scholar 

  2. Marshall WF, Keating MR, Anhalt JP, Steckelberg JM. Xanthomonas maltophilia: an emerging nosocomial pathogen. Mayo Clin Proc 1989; 54: 1097–1104.

    Google Scholar 

  3. Gutiérrez Rodero F, Masia MM, Cortés J, Ortiz de la Tabla V, Mainar V, Vilar A. Endocarditis caused by Stenotrophomonas maltophilia: case report and review. Clin Infect Dis 1996; 23: 1261–1265.

    Google Scholar 

  4. Van Couwenberghe CJ, Farver TB, Cohen SH. Risk factors associated with isolation of Stenotrophomonas (Xanthomonos) maltophilia in clinical specimens. Infect Control Hosp Epidemiol 1997; 18: 316–321.

    Article  Google Scholar 

  5. Cornwell EE 3rd, Willey P, Belzberg H, Berne TV, Morales IR, Demetriades D. Characteristics of Xanthomonas infections in critically ill surgical patients. Am Surg 1996; 62: 478–480.

    Google Scholar 

  6. Papadakis KA, Vartivarian SE, Vassilaki ME, Anaissie EJ. Stenotrophomonas maltophilia meningitis. Report of two cases and review of the literature. Clin Infect Dis 1997; 87: 106–108.

    CAS  Google Scholar 

  7. Vartivarian SE, Papadakis KA, Palacios JA, Manning JT Jr, Annaissie EJ. Mucocutaneous and soft-tissue infections caused by Xanthomonas maltophilia. A new spectrum. Ann Intern Med 1994; 121: 969–973.

    PubMed  CAS  Google Scholar 

  8. Pederzoli P, Bassi C, Vesentini S, Campedelli A. A randomized multicenter clinical trial of antibiotic prophylaxis of septic complications in acute necrotizing pancreatitis with imipenem. Surg Gynecol Obstet 1993; 176: 480–483.

    PubMed  CAS  Google Scholar 

  9. Baron TH, Thaggard WG, Morgan DE, Stanley RJ. Endoscopic therapy for organized pancreatic necrosis. Gastroenterology 1996; 111: 755–764.

    Article  Google Scholar 

  10. Ranson JH, Rifkind KM, Roses DF, Fink SD, Eng K, Spencer FC. Prognostic signs and the role of operative management in acute pancreatitis. Surg Gynecol Obstet 1974; 139: 69–81.

    PubMed  CAS  Google Scholar 

  11. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med 1985; 13: 818–829.

    Article  PubMed  CAS  Google Scholar 

  12. Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology 1990; 174: 331–336.

    PubMed  CAS  Google Scholar 

  13. Mönkemüller KE, Morgan DE, Baron TH. Transmural drainage of pancreatic collections without electrocautery using the Seldinger technique. Gastrointest Endosc 1998; 48: 195–200.

    Article  PubMed  Google Scholar 

  14. Bruckner DA, Colonna P. Nomenclature for aerobic and facultative bacteria Clin Infect Dis 1995; 21: 263–272.

    PubMed  CAS  Google Scholar 

  15. Palleroni NJ, Bradbury JF. Stenotrophomonas, a new bacterial genus for Xanthomonas maltophilia. Int J Syst Bacteriol 1993; 43: 606–609.

    Article  PubMed  CAS  Google Scholar 

  16. Szeto CC, Li PK, Leung CB, Yu AW, Lui SF, Lai KN. Xanthomonas maltophilia peritonitis in uremic patients receiving continuous ambulatory peritoneal dialysis. Am J Kidney Dis 1997; 29: 91–95.

    Article  PubMed  CAS  Google Scholar 

  17. Papadakis KA, Vartivarian SE, Vassilaki ME, Anaisse EJ. Stenotrophomonas maltophilia: an unusual cause of biliary sepsis. Clin Infect Dis 1995; 21: 1032–1034.

    PubMed  CAS  Google Scholar 

  18. Chambers HF, Neu HC. Other β-lactam antibiotics, in Principles and Practice of Infectious Diseases, Mandell GL, Bennett JE, Dolin R, eds. Churchill Livingstone, New York, 1995; 17: 264–271.

    Google Scholar 

  19. Ljubicic N, Bilic A. Inflammed pancreatic pseudocyst: optimization of pseudocyst fluid culture technique. Z Gastroenterol 1993; 31: 198–200.

    PubMed  CAS  Google Scholar 

  20. Carmeli Y, Samore MH. Comparison of treatment with imipemem vs. ceftazidime as a predisposing factor for nosocomial acquisition of Stenotrophomonas maltophilia: a historical cohort study. Clin Infect Dis 1997; 24: 1131–1134.

    Article  PubMed  CAS  Google Scholar 

  21. Rau B, Uhl W, Buchler MW, Beger HG. Surgical treatment of infected necrosis. World J Surg 1997; 21: 155–161.

    Article  PubMed  CAS  Google Scholar 

  22. Baron TH, Morgan DE. The diagnosis and management of fluid collections associated with pancreatitis. Am J Med 1997; 102: 555–563.

    Article  PubMed  CAS  Google Scholar 

  23. Pinkas H, Dolan RP, Brady PG. Successful endoscopic transpapillary drainage of infected pancreatic pseudocyst. Gastrointest Endosc 1994; 40: 97–99.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Alabama at Birmingham, Birmingham, AL

    Klaus E. Mönkemüller

  2. Department of Radiology, University of Alabama at Birmingham, Birmingham, AL

    Desiree E. Morgan

  3. Departments of Medicine, Divisions of Gastroenterology and Hepatology, Mayo Medical School, Rochester, MN

    Todd H. Baron

Authors
  1. Klaus E. Mönkemüller
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Desiree E. Morgan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Todd H. Baron
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Todd H. Baron.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mönkemüller, K.E., Morgan, D.E. & Baron, T.H. Stenotrophomonas (Xanthomonas) maltophilia infection in necrotizing pancreatitis. International Journal of Pancreatology 25, 59–63 (1999). https://doi.org/10.1385/IJGC:25:1:59

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1385/IJGC:25:1:59

Key Words

Search

Navigation