Myocardial abscess from Stenotrophomonas maltophilia endocarditis in an adolescent

A 13-year-old girl developed infective endocarditis (IE) on the native mitral valve after hospitalization for osteomyelitis. The clinical course was complicated by intramyocardial abscess and severe mitral regurgitation. Blood cultures were positive for <i>Stenotrophomonas maltophilia</i>, a rare cause of IE, which is known to be resistant to the first-line agents used for the treatment of IE, and has a propensity to cause a myocardial abscess. Hence, an increased awareness regarding endocarditis due to <i>S. maltophilia</i> is warranted.