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Correspondence to Author: Kasahun Benti (M.D, Internist and Nephrologist), Fitsum Solomon (M.D), Zemedkun Motera(M.D, Emergency and Critical Care Specialist), Yabetse Dereje (M.D). 

Teklehaimanot General Hospital Addis Ababa,Ethiopia.

Abstract

Introduction: ESRD culminates from various pathophysiologic processes leading to progressive renal dysfunction. Progressive decline in GFR stems from genetic abnormalities, Immune complex depositions, inflammation, and toxins, in which a dysregulated immune response and lack of protective mechanisms cause immune impairment. ESRD patients on hemodialysis require utmost clinical care, a high index of suspicion of infection, and meticulous follow-up of clinical deterioration.
Case Description: A 42-year-old male with End Stage Renal Disease, Type 1 Diabetes Mellitus, Hypertension, and Hypothyroidism presented with a 1-week history of productive cough, fever, difficulty breathing, and loss of appetite. Physical exams, laboratory, and imaging findings were suggestive of community-acquired pneumonia. Culture from the pleural fluid grew Stenotrophomonas maltophilia susceptible to TMP/SMX, Levofloxacin, Ceftazidime, and Minocycline. He was treated with Levofloxacin with a good clinical outcome.
Discussion: Stenotrophomonas maltophilia is a gram-negative, rod-shaped obligate aerobe that persists in a harsh environment, causing both hospital-acquired as well as community-acquired infections. With the greater tendency of resistance to elimination by the host’s immune system, anti-microbials and antiseptic solutions contribute to the increased prevalence of its infection, along with the pathogenic virulence in patients with CKD undergoing hemodialysis. Drug susceptibility testing is of paramount importance pertaining to the antibiotic selection.
Conclusion: CKD patients are prone to opportunistic infections due to the weakened immune system and frequent hospitalizations. S maltophilia is among the rare causes of pneumonia and bacteremia in CKD patients undergoing hemodialysis, mandating drug susceptibility testing and rational antibiotic selection

Citation:

Fitsum Solomon (M.D), Stenotrophomonas Maltophilia Pneumonia In A Patient With End-Stage Renal Disease On Hemodialysis: Case Report. The Journal of Nephrology 2025.