Stenotrophomonas maltophilia right-sided endocarditis in an adult patient with uncorrected congenital heart disease

Abstract

•Stenotrophomonas maltophilia is a Gram negative, low virulence, one of the leading multiple-drug-resistant pathogen and quite often causes nosocomial infection.•Bacteremia with Stenotrophomonas maltophilia has higher mortality than Pseudomonas aeruginosa.•Stenotrophomonas maltophilia endocarditis is too scarce, however, it accompanied with high rates of mortality and morbidity.•Acute bacterial endocarditis due to Stenotrophomonas maltophilia can occur even in patients with uncorrected congenital heart disease and lack of immune deficiency, therefore. clinicians should be aware.

Fig. 1

Images A & B images demonstrate destroyed & flailing tricuspid valve (TV), in addition to attached & mobile vegetations in different sizes (white arrow heads). Image C demonstrates a small size vegetation attached to the right side of VSD (black arrow head with white margins). A. Transthoracic (TTE) apical four chamber off-axis view. B. Transeophageal (TEE) four chamber view (mid esophageal. C. TTE four chamber view (modified mid esophageal). D. Color Doppler TEE (in the same view as shown in image C). Abbreviations: AO: aorta. IVS: interventricular septum, LA: left atrium, LV: left ventricle, MV: mitral valve, RA: right atrium, RV: right ventricle.