Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
ORIGINAL ARTICLES
Clinical Characteristics of Rapidly Progressive Fatal Hemorrhagic Pneumonia Caused by Stenotrophomonas maltophilia
Waki Imoto, Koichi Yamada, Kazushi Yamairi, Wataru Shibata, Hiroki Namikawa, Satomi Yukawa, Naoko Yoshii, Kiyotaka Nakaie, Asao Hirose, Hideo Koh, Tetsuya Watanabe, Kazuhisa Asai, Hirohisa Nakamae, Yukihiro Kaneko, Tomoya Kawaguchi, Masayuki Hino, Hiroshi Kakeya
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Keywords: bacteremia, hemorrhagic pneumonia, quinolone, Stenotrophomonas maltophilia
JOURNAL OPEN ACCESS

2020 Volume 59 Issue 2 Pages 193-198

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Abstract

Objective Hemorrhagic pneumonia due to Stenotrophomonas maltophilia (SM) in severely immunocompromised patients has a very poor prognosis. However, the risk factors for hemorrhagic pneumonia are not clear.

Methods This study assessed the predictive factors of hemorrhagic pneumonia caused by SM. The medical records of patients admitted to Osaka City University Hospital with SM bacteremia between January 2008 and December 2017 were retrospectively reviewed.

Patients All patients who had positive blood cultures for SM were included in this study. They were categorized into two groups: the SM bacteremia with hemorrhagic pneumonia group and the SM bacteremia without hemorrhagic pneumonia group. The clinical background characteristics and treatments were compared between these groups.

Results The 35 patients with SM bacteremia included 4 with hemorrhagic pneumonia and 31 without hemorrhagic pneumonia. Hematologic malignancy (p=0.03) and thrombocytopenia (p=0.04) as well as the prior use of quinolone within 30 days (p=0.04) were more frequent in the SM bacteremia patients with hemorrhagic pneumonia than in those without hemorrhagic pneumonia. The mortality of the SM bacteremia patients with hemorrhagic pneumonia was higher than that of those without hemorrhagic pneumonia group (p=0.02).

Conclusion Patients with SM bacteremia who have hematologic malignancy, thrombocytopenia, and a history of using quinolone within the past 30 days should be treated with deliberation.

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© 2020 by The Japanese Society of Internal Medicine
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