A previously healthy 71-y-old male developed acute upper airway obstruction caused by a Stenotrophomonas maltophilia infection of the mucocutaneous and soft tissue of the neck. Ventilator support was provided via a small-calibre endotracheal tube. Stenotrophomonas was susceptible only to levofloxacin and cotrimoxazole. Antibiotic therapy rapidly improved the soft tissue oedema, allowing extubation and discharge from the intensive care unit.