Co-transmission of Stenotrophomonas maltophilia and leishmaniasis by Phlebotomus argentipes (sandfly)? A case report

A 47-year-old male with a history of lepromatous leprosy and long-term steroid use for erythema nodosum leprosum presented with intermittent fever and developed S. maltophilia bacteremia together with cutaneous leishmaniasis. The patient lived in an area endemic for leishmaniasis transmitted by the Phlebotomus argentipes (sandfly). We explore the possibility of co-transmission of both pathogens by the sandfly, as S. maltophilia was isolated from blood culture and leishmaniasis confirmed by skin smear. Fever resolved with co-trimoxazole. This case raises the possibility of vector-borne transmission of S. maltophilia, which was not previously documented. • S. maltophilia is an opportunistic pathogen known to cause nosocomial infection. • Transmission of S. maltophilia by a vector is not described in the literature. • P. argentipes may be a vector for S. maltophilia. • Leishmania and S. maltophilia can co-infect.