Stenotrophomonas maltophilia: An unusual cause of biliary sepsis

We report three cases of cholangitis caused by Stenotrophomonas maltophilia and review two other cases reported in the literature. All five episodes occurred in patients with hepatobiliary malignancy complicated by biliary tract obstruction. All patients had undergone biliary tract instrumentation. Before infection developed, four of the five patients had received therapy with antibiotics that do not have in vitro activity against this organism. Four patients responded to appropriate antibiotic therapy and biliary tract decompression, whereas the fifth patient, who had persistent biliary obstruction, did not respond to appropriate antibiotic therapy.