Non healing leg ulcer infected with Stenotrophomonas maltophilia: first reported case from India

Abstract

Stenotrophomonas maltophilia is a recently described organism which was mainly reported either in nosocomial setup, or in immunosuppresed individuals. This was rarely reported as cutaneous pathogenic organism causing cellulitis-like lesion, paronychia, mucocutaneous ulcers and ecthyma gangrenosum in immunocompromised individuals. Here we describe a case of leg ulcer caused by S. maltophilia in an immuno-competent patient. The infection was possibly community acquired as the patient had no exposure to hospital environment. The bacillus was sensitive to cotrimoxazole and levofloxacin, and the patient was successfully treated with cotrimoxazole. Our case is unique not only because it is probably the first ever case of leg ulcer caused by S. maltophilia, but also because of its unusual occurrence in immunocompetent patient.

Figure 1

Infected ulcer on presentation.

Figure 2

Growth on McConkey's agar.

Figure 3

Cotrimoxazole and levofloxacin sensitivity.

Figure 4

Ulcer healing after 1 week.