Serratia Marcescens Septic Arthritis of the Ankle in a Compromised Host: Ring Fixator Arthrodesis as Salvage, a Case Report

Serratia marcescens is an opportunistic Gram-negative bacterium infrequently implicated in septic arthritis, with ankle involvement reported only in isolated cases.

We present a 45-year-old male with systemic lupus erythematosus on long-term corticosteroids, prior ischemic stroke with residual left hemiparesis, and end-stage renal disease on hemodialysis through a permanent catheter, who developed septic arthritis of the left ankle following a recent episode of presumptive hospital-acquired pneumonia. Concurrent blood and joint aspirate cultures both confirmed S. marcescens with antimicrobial susceptibilities largely retained (resistant only to ceftriaxone and cefoperazone-sulbactam), supporting.

This case highlights the importance of considering a broad range of pathogens in immunocompromised patients with acute monoarthritis, the value of concurrent blood and synovial cultures in identifying the infectious source, and the use of ring fixator arthrodesis as a biologically appropriate solution for infected, systemically compromised joints.