title: [Lethal pulmonary hemorrhage caused by Stenotrophomonas maltophilia pneumonia in a patient with acute myeloid leukemia].
abstract: A 63-year-old man had been treated with intensive chemotherapy for acute myeloid leukemia. On the 49th hospital day, he had febrile neutropenia after the second course of induction chemotherapy. On the 53 rd hospital day, he presented with hemoptysis and developed acute respiratory failure requiring ventilator support within several hours. On the 54th hospital day, the patient died with hemorrhagic respiratory infection. Stenotrophomonas maltophilia was detected in bacterial cultures of his blood, bronchoalveolar lavage, and sputum. To our knowledge, nine cases of fatal hemorrhagic pneumonia caused by S. maltophilia have been reported in the literature. All the patients had hematological neoplasms and were severely neutropenic after one or two intensive chemotherapy regimens. They died shortly (within 3 days) after the onset of the hemorrhagic pneumonia. Management of the infection caused by S. maltophilia is hampered by high-level intrinsic resistance to multiple antibiotics and the increasing occurrence of acquired resistance to co-trimoxazole and fluoroquinolones. It would be important to keep in mind that hemorrhagic respiratory infection caused by S. maltophilia may lead to a fulminant and lethal course in severely neutropenic patients with hematological neoplasms and to recognize which antibiotic agents are more sensitive to S. maltophilia in each institution.
authors: Department of Hematology, Kokura Memorial Hospital.
authors: Minako
authors: M
authors: Mori
authors: Tomoya
authors: T
authors: Kitagawa
authors: Yuya
authors: Y
authors: Sasaki
authors: Kazuyo
authors: K
authors: Yamamoto
authors: Takashi
authors: T
authors: Onaka
authors: Akihito
authors: A
authors: Yonezawa
authors: Kazunori
authors: K
authors: Imada
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D003561:Cytarabine / Q000008:administration & dosage; D003630:Daunorubicin / Q000008:administration & dosage; D017809:Fatal Outcome; D016905:Gram-Negative Bacterial Infections / Q000150:complications*; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000188:drug therapy*; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000150:complications*; D020615:Stenotrophomonas maltophilia
chemical_list: D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D003561:Cytarabine; D003630:Daunorubicin