Stenotrophomonas maltophilia endocarditis of prosthetic aortic valve: Report of a case and review of literature

Stenotrophomonas maltophilia (previously known as Xanthomonas maltophilia a nd Pseudomonas maltophilia) is an aerobic, nonfermenting, gram-negative bac illus, which has emerged as a serious nosocomial pathogen in patients with compromised immunity. It is a rare cause of endocarditis with only 20 cases previously reported in medical literature. The risk factors associated wit h S maltophilia endocarditis include intravenous drug abuse, dental treatme nt, previous cardiac surgery, and infected intravascular devices. S maltoph ilia is resistant to multiple antibiotics, which leads to frequent therapeu tic failures. Although the optimal antibiotic treatment for S maltophilia e ndocarditis remains unknown, most of the patients received 2 or more antibi otics. We report a case of S maliophilia endocarditis of prosthetic aortic valve, associated with a painless aortic dissection, that responded well to a combination of ciprofloxacin and chloramphenicol. The literature is revi ewed to elaborate the disease characteristics, the treatments used, and the prognosis of the S maltophilia endocarditis.