title: Serratia marcescens endocarditis: a regional illness associated with intravenous drug abuse.
abstract: From 1969 to 1974, 19 cases of Serratia marcescens endocarditis were observed in the San Francisco Bay Area. Seventeen patients were intravenous drug users, and Serratia caused 14% of all addict-associated endocarditis in San Francisco. Serratia strains were nonpigmented and had typical antibiotic sensitivities, except that 9 of the isolates exhibited colonial variation, with each variant having different antibiotic sensitivities. Aortic or mitral valves were involved in 13 patients, and heart failure developed in 9 of these. Twelve patients had embolic episodes to brain, iliofemoral arteries, or lung. Five of 6 patients with tricuspid valvulitis were cured by antibiotics either with (1) or without excision of the valve. All 12 patients with aortic or mitral valvulitis treated medically died; 11 had unremitting sepsis. Aortic valve replacement and antibiotics were effective in 1. Gentamicin combined with either carbenicillin or chloramphenicol was the most effective treatment regimen.
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve; D002140:California; D002228:Carbenicillin / Q000627:therapeutic use; D002701:Chloramphenicol / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D006350:Heart Valve Prosthesis; D006801:Humans; D007612:Kanamycin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012706:Serratia marcescens / Q000302:isolation & purification*; D019966:Substance-Related Disorders / Q000150:complications*
chemical_list: D005839:Gentamicins; D007612:Kanamycin; D002701:Chloramphenicol; D002228:Carbenicillin