title: Serratia marcescens osteomyelitis in Cushing's disease.
abstract: We report a case of a 46-year-old man with fever, hypotension and arthralgias of the ankles and knees after brain surgery for a pituitary tumour causing Cushing's disease. Blood and urine cultures isolated Serratia marcescens; antibiotic susceptibility testing showed sensitivity to piperacillin-tazobactan and ciprofloxacin. Articular MRI showed inflammation and necrosis of both knees and ankles, and left hip and right elbow (compatible with osteomyelitis). Culture of an ankle abscess on the ankle joint was positive for Serratia marcescens. Bone scintigraphy confirmed osteomyelitic lesions. Medical treatment included antibiotics and strong opioid therapy for 14 weeks. The patient was discharged clinically improved maintaining ciprofloxacin for 24 additional weeks based on clinical and analytic recovery.
authors.affiliation: Unidade Funcional Medicina Interna 1.2, Hospital São José, Lisboa, Portugal.
authors.forename: Hugo F G
authors.initials: HF
authors.lastname: Martins
authors.affiliation: Unidade Funcional Medicina Interna 1.2, Hospital São José, Lisboa, Portugal.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Raposo
authors.affiliation: Unidade Funcional Medicina Interna 1.2, Hospital São José, Lisboa, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Baptista
authors.affiliation: Unidade Funcional Medicina Interna 1.2, Hospital São José, Lisboa, Portugal.
authors.forename: Julio
authors.initials: J
authors.lastname: Almeida
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis* / Q000188:drug therapy; D047748:Pituitary ACTH Hypersecretion / Q000150:complications*; D016868:Serratia Infections / Q000175:diagnosis* / Q000188:drug therapy; D012706:Serratia marcescens / Q000302:isolation & purification*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents