Hemorrhagic Pneumonia due to Stenotrophomonas maltophilia in a Patient with Systemic Lupus Erythematosus-associated Thrombotic Microangiopathy under Immunosuppressive Therapy
Abstract
A 61-year-old woman with systemic lupus erythematosus was admitted with persistent pericardial effusion. Blood tests suggested thrombotic microangiopathy (TMA). Treatment with methylprednisolone, fresh-frozen plasma, and rituximab was initiated after tacrolimus discontinuation. A renal biopsy revealed endothelial injury and glomerular capillary thrombi, consistent with TMA. The patient developed severe anemia and bilateral lung opacities. Bronchoalveolar lavage revealed alveolar hemorrhaging and Stenotrophomonas maltophilia, indicating hemorrhagic pneumonia. Although chest radiography showed improvement with minocycline and levofloxacin treatment, she ultimately succumbed to Candida albicans sepsis. Hemorrhagic pneumonia-causing pathogens, such as S. maltophilia, should be considered when alveolar hemorrhaging occurs during immunosuppressive therapy.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Severe clinical outcomes of COVID-19 associated with proton pump inhibitors: a nationwide cohort study with propensity score matching
- Levofloxacin-Induced Tendon Rupture: A Case Report and Review of the Literature
- Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA)
- Neuroprotective Effects of Epicatechin against Oxidative Stress-Induced Cognitive Impairment: A Systematic Review and Meta-Analysis
- Quality evaluation and in vitro interaction studies between levofloxacin 250mg and diclofenac sodium 50mg tablets
- Molecular Epidemiology of mcr-1 -Positive Polymyxin B-Resistant Escherichia coli Producing Extended-Spectrum β-Lactamase (ESBL) in a Tertiary Hospital in Shandong, China
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.