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Serratia marcescens Endocarditis
1Augusta University, GA, USA.
Abstract:
Severe infections due to Serratia marcescens have been documented with increasing frequency in persons who inject drugs and are frequently associated with nosocomial outbreaks. S marcescens endocarditis is rare, and there are very few, if any, reported cases secondary to an infected wound acquired at home. We present such a case in an immunocompetent 50-year-old man with paraplegia for 30 years and chronic decubitus ulcers who likely contracted the rare opportunistic Serratia following sacral wound contact with unclean surfaces in his hotel room bathroom. While it is also possible that the organism was obtained during a hospital admission 2 months before the positive blood cultures, he was found sitting with his ulcer in direct contact with red-pigmented accumulations on the shower floor. Therefore, it is more likely that he acquired the infection outside of the hospital setting. Early and effective management with advanced cardiac techniques and appropriate antibiotic coverage resulted in a positive outcome.
Insights
This case highlights a rare Serratia marcescens endocarditis infection acquired from a home environment, not a hospital. Prompt treatment led to a successful recovery, emphasizing the importance of environmental hygiene.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Serratia marcescens infections are increasingly reported in specific populations and hospital settings.
- Serratia marcescens endocarditis is a rare clinical manifestation.
- Opportunistic infections can arise from chronic conditions like decubitus ulcers.
Observation:
- A 50-year-old immunocompetent male with chronic paraplegia and decubitus ulcers presented with a severe infection.
- The patient likely acquired Serratia marcescens from contact with contaminated surfaces in a hotel bathroom.
- The infection was suspected to originate from a sacral wound, distinct from recent hospital admissions.
Findings:
- The case details a rare instance of Serratia marcescens endocarditis.
- The probable source of infection was identified as environmental contamination outside a healthcare facility.
- Effective management involved advanced cardiac interventions and targeted antibiotic therapy.
Implications:
- Highlights the potential for opportunistic pathogens like Serratia marcescens to cause severe infections in non-hospital settings.
- Underscores the importance of environmental hygiene, even in seemingly low-risk domestic or travel environments.
- Demonstrates the successful management of a rare Serratia marcescens endocarditis case with prompt and appropriate medical intervention.
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