Xanthogranulomatous Pyelonephritis Caused by Stenotrophomonas maltophilia—The First Case Report and Brief Review

Pathogens

Daniel Damian¹  Cristian Mareș²  Răzvan-Ionuț Popescu²  Viorel Jinga²  Aida Petca²  Răzvan-Cosmin Petca²  Răzvan-Alexandru Dănău² 

[1]Department of Urology, “Prof. Dr. Theodor Burghele” Clinical Hospital, 050659 Bucharest, Romania

[2]“Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania

关键词: Stenotrophomonas maltophilia;    Xanthogranulomatous pyelonephritis;    XGP;    urinary tract infection;    renal stone;    nephrectomy;   

DOI  :  10.3390/pathogens11010081

来源: DOAJ

【 摘 要 】

Xanthogranulomatous pyelonephritis (XGP) represents a rare and severe pathology secondary to chronic urinary obstruction and recurrent infections. Commonly, this condition leads to loss of kidney function, and frequently, surgical approach is the only optional treatment. Proteus mirabilis and Escherichia coli are the most frequent pathogens associated with XGP. The actual changes in the pathogen’s characteristics increased the risk of newly acquired infections once considered opportunistic. Stenotrophomonas malthophilia is one of those agents more related to immunocompromised patients, presenting an increased incidence and modified antibiotic resistance profile in the modern era. This case report presents a healthy female patient with an underlying renal stone pathology diagnosed with XGP related to S. maltophilia urinary infection. After a complete biological and imagistic evaluation, the case was treated as pyonephrosis. Empirical antibiotic administration and a surgical approach were considered. A total nephrectomy was performed, but the patient’s condition did not improve. The patient’s status improved when specific antibiotics were administered based on the bacterial identification and antibiotic susceptibility pattern of drained perinephric fluid. Levofloxacin and Vancomycin were considered the optimal combination in this case. The histopathological examination revealed XGP secondary to chronic renal stone. The present study describes the first case of XGP related to an aerobic Gram-negative pathogen such as S. maltophilia, once considered opportunistic, in an apparently healthy female adult.

【 授权许可】

Unknown