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Late Subcutaneous Infection Caused by Serratia marcescens Following Hyaluronic Acid Injection: A Case Report and
Yihan Zhang1,2, Yansi Lyu3, Tingyin Lin1,2
1Department of Plastic and Reconstructive Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong, P.R. China.
Journal of Cosmetic Dermatology
|September 17, 2024
Summary
Serratia marcescens infections after hyaluronic acid fillers are rare but serious. Quinolones and trimethoprim-sulfamethoxazole are effective treatments for these cutaneous infections.
Area of Science:
- Dermatology
- Infectious Diseases
- Cosmetic Surgery
Background:
- Hyaluronic acid (HA) fillers are widely used for facial augmentation.
- Gram-negative bacteria are common causes of HA filler infections.
- Cutaneous infections from Serratia marcescens are rare, especially in immunocompetent individuals.
Purpose of the Study:
- To summarize clinical features, diagnosis, and treatment of Serratia marcescens subcutaneous infections post-HA injection.
- To review literature on managing S. marcescens skin infections in immunocompetent patients.
Main Methods:
- Case report of S. marcescens infection after HA injection.
- Literature review of 11 cases (3 series, 8 reports) from 1999-2017.
- Data extraction on patient demographics, symptoms, treatments, and outcomes.
Main Results:
- Serratia marcescens presented as abscesses, nodules, or ulcers.
- Quinolones were the most effective salvage treatment (72.73% recovery).
- Trimethoprim-sulfamethoxazole was the second most effective (18.18% recovery).
Conclusions:
- Pathogen identification and drug sensitivity testing are crucial.
- First-line treatment for S. marcescens infection includes sensitive aminoglycosides, quinolones (e.g., moxifloxacin), or TMP-SMX for at least two weeks.
- Effective antibiotic selection ensures successful management of these rare infections.
