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Spontaneous Cervical Epidural Abscess Caused by Serratia Marcescens
Idris Sertbas1, Derya Bayirli Turan1, Mete Mete Karatay1
1Department of Neurosurgery, Yeni Yuzyil University, Medical Faculty, Istanbul, Turkey.
Abstract:
Serratia marcescens infections are very rare and usually occur in the form of nosocomial and opportunistic infections. The subjects usually have severe medical comorbidities such as immunosuppression, diabetes mellitus, and renal failure. Spontaneous Serratia marcescens infection is very rare. In this case, we demonstrate that it can be seen in the spontaneous cervical epidural abscess. A 54-year female patient presented with a complaint of weakness in the left arm. Cervical magnetic resonance imaging revealed a spinal epidural abscess at the C5-6 level. Surgery was planned for this lesion. The abscess that created a cervical mass effect was totally removed and treatment with oral antibiotics was continued due to S. marcescens growth in the culture. This is the first case where S. marcescens has caused the development of a cervical epidural abscess in a patient without any medical comorbidity. Key Words: Serratia marcescens, Spinal epidural abscess, Vertebral osteomyelitis, Cervical discitis.
Insights
Serratia marcescens rarely causes spontaneous infections. This case highlights its potential to cause a cervical epidural abscess, even in patients without underlying health issues.
Area of Science:
- Infectious Diseases
- Neurosurgery
- Microbiology
Background:
- Serratia marcescens (S. marcescens) infections are uncommon, typically occurring as nosocomial or opportunistic infections.
- These infections usually affect individuals with severe comorbidities, including immunosuppression, diabetes mellitus, and renal failure.
- Spontaneous S. marcescens infections are exceptionally rare.
Observation:
- A 54-year-old female presented with left arm weakness.
- Cervical magnetic resonance imaging identified a spinal epidural abscess at the C5-C6 level.
- The patient had no significant medical comorbidities.
Findings:
- Surgical removal of the cervical epidural abscess was performed.
- Cultures confirmed the presence of S. marcescens.
- The patient was treated with oral antibiotics post-surgery.
Implications:
- This case represents the first documented instance of S. marcescens causing a cervical epidural abscess in a patient without prior medical comorbidities.
- It expands the known spectrum of spontaneous Serratia infections.
- Highlights the importance of considering rare pathogens in the differential diagnosis of spinal epidural abscesses, irrespective of patient risk factors.
