Article in Japanese

A case of anorexia nervosa with central line-associated bloodstream infection caused by Stenotrophomonas maltophilia

Kenta SUZUKI^1）, Kazufumi YAGINUMA^1）, Yuichirou ASANO^1）, Masahiro WATANABE^1）, Masatoki SATO^1）, Mitsuaki HOSOYA^1）

many antimicrobial agents, including carbapenems. This bacterium does not show pathogenicity in an immunocompetent patient, but often causes severe disease in an immunocompromised one. This report presents the case of anorexia nervosa (AN) in an 11-yearold
girl, who developed a central line-associated bloodstream infection (CLABSI) caused by S. maltophilia during her treatment. She was hospitalized in this hospital, due to rapid weight loss with poor food intake, and diagnosed with AN. A peripherally inserted central venous catheter (PICC) was required for central venous nutrition, focusing on refeeding syndrome development. Two months after initiation of central venous nutrition, she presented sudden fever, chills and poor vitality. She was transferred to the pediatric intensive care unit for further treatment due to suspected CLABSI development. The PICC was removed promptly and the patient was given vancomycin and meropenem intravenously. Her blood sample was collected and S. maltophilia isolated from it on the following day. Subsequently, the susceptible antibacterial agents, trimethoprim-sulfamethoxazole and minocycline, were administered intravenously. Her condition improved on the next day of treatment by using these agents. Thus, AN patients must be immunocompromised due to long-term malnutrition. CLABSI should be suspected when these patients present with sudden fever during central venous nutrition,
and the central catheter should be removed and appropriate microbial agents administered as soon as possible.

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1）Department of Pediatrics, Fukushima Medical University

Key words	anorexia nervosa, Stenotrophomonas maltophilia, central venous catheterrelated bloodstream infections
Received	April 2, 2021
Accepted	September 22, 2021

33 (4)：366─373,2021