We report three cases of cholangitis caused by Stenotrophomonas maltop
hilia and review two other cases reported in the literature. All five
episodes occurred in patients with hepatobiliary malignancy complicate
d by biliary tract obstruction. All patients had undergone biliary tra
ct instrumentation, Before infection developed, four of the five patie
nts had received therapy with antibiotics that do not have in vitro ac
tivity against this organism. Four patients responded to appropriate a
ntibiotic therapy and biliary tract decompression, whereas the fifth p
atient, who had persistent biliary obstruction, did not respond to app
ropriate antibiotic therapy.