Acute dermal abscesses caused by Serratia marcescens

Area of Science:

• Immunology
• Infectious Diseases
• Dermatology

Background:

• Primary acute cutaneous infections caused by Serratia marcescens are exceptionally rare.
• Serratia infections are more common in individuals with chronic granulomatous disease, a primary immunodeficiency affecting innate immune phagocytic cells.

Observation:

• A young man presented with multiple dermal abscesses on a leg affected by chronic lymphoedema.
• The abscesses were attributed to Serratia marcescens.
• Laboratory tests revealed a delayed partial neutrophilic oxidative function.

Findings:

• The patient had no prior history of infections or granulomatous lesions, unusual for typical innate immune deficiencies diagnosed in childhood.
• This presentation suggests a potentially milder or atypical form of neutrophilic oxidative dysfunction.

Implications:

• The findings suggest that partial neutrophilic oxidative dysfunction may allow individuals to remain asymptomatic until a specific infection triggers symptoms.
• This case broadens the understanding of the clinical spectrum of chronic granulomatous disease and related immunodeficiencies.
• Highlights the importance of considering immunodeficiency in unusual cutaneous infections, even in the absence of a typical history.