Hemorrhagic Pneumonia in a Kidney Transplant Recipient Caused by Stenotrophomonas Maltophilia Infection: A Case Report
•Ticagrelor antithrombotic treatment can cause a significant increase in everolimus blood concentration, which can lead to severe immunosuppression, increasing the development of opportunistic infections.•Our case demonstrates that Stenotrophomonas maltophilia hemorrhagic pulmonary infection can occ...
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| Published in: | Transplantation proceedings Vol. 56; no. 5; pp. 1192 - 1195 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Elsevier Inc
01-06-2024
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | •Ticagrelor antithrombotic treatment can cause a significant increase in everolimus blood concentration, which can lead to severe immunosuppression, increasing the development of opportunistic infections.•Our case demonstrates that Stenotrophomonas maltophilia hemorrhagic pulmonary infection can occur without leukopenia and is independent of S. maltophilia bloodstream infection.•Rapid onset of thrombocytopenia associated with S. maltophilia infection and concomitant ticagrelor treatment can lead to hemorrhagic pneumonia.•Not only dyspnea and thrombocytopenia but also severe hyperkalemia, elevated concentrations of creatine kinase, lactate dehydrogenase, C-reactive protein, and interleukin-6 may indicate hemorrhagic pneumonia
Pneumonia is a common nosocomial complication in transplant patients. Stenotrophomonas maltophilia is recognized as a common cause and is typically seen in immunocompromised and critically ill patients. S. maltophilia, a nonfermenting gram-negative rod, ranks as the third most common nosocomial pathogen, following Pseudomonas aeruginosa and Acinetobacter. The bacteria are frequently found in environmental sources and are prevalent in healthcare facilities, including in tap water faucets, shower outlets, air-cooling systems, intravenous fluids, catheters, dialysis machines, and oxygen humidifiers. This bacterium possesses the ability to rapidly form biofilms, enabling it to colonize new surfaces in less than 24 hours. While S. maltophilia generally exhibits low virulence, there remains uncertainty among many clinicians regarding whether it is merely a colonizer or the primary cause of infection. Although S. maltophilia infections are rare in immunocompetent individuals, the species is increasingly recognized as an opportunistic pathogen in vulnerable populations such as those with cystic fibrosis, cancer, and other conditions leading to immunosuppression. S. maltophilia now recognized as a causative agent in various clinical syndromes, primarily affecting the lungs and bloodstream. We present a case of S. maltophilia-associated lung infection in a kidney transplant recipient, emphasizing the significance of underlying diseases and associated signs and symptoms. |
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| Bibliography: | ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3 |
| ISSN: | 0041-1345 1873-2623 1873-2623 |
| DOI: | 10.1016/j.transproceed.2024.05.016 |