title: Necrotizing soft tissue infection caused by Serratia marcescens: A case report and literature review.
abstract: A 64-year-old man with advanced liver cirrhosis was transferred to an emergency center due to septic shock and markedly inflamed left leg. Under a clinical diagnosis of necrotizing soft tissue infection (NSTI), the patient undertook intensive therapy but died 25 h after arrival. The pathogenic organism, Serratia marcescens, was later isolated from blood and soft tissue cultures. NSTI is very rarely associated with S. marcescens. A literature review showed that only 16 such cases, including our case, have been reported to date. Our case is the first evidence of an S. marcescens NSTI in a patient with liver cirrhosis. S. marcescens NSTI has an extremely high mortality rate; total mortality and mortality in cases involving the extremities were 75% (12 of 16 cases) and 83.3% (10 of 12 cases), respectively. Physicians need to be aware that S. marcescens can induce fatal infections in community patients.
authors.affiliation: Division of Infection Control and Prevention, Osaka University Hospital, Japan. Electronic address: highgear@hp-infect.med.osaka-u.ac.jp.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Hagiya
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Hospital, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ojima
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Hospital, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Department of Pathology, Osaka University Hospital, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Matsui
authors.affiliation: Department of Pathology, Osaka University Hospital, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Morii
authors.affiliation: Department of Pathology, Osaka University Hospital, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Pathology, Osaka University Hospital, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Tahara
authors.affiliation: Division of Infection Control and Prevention, Osaka University Hospital, Japan.
authors.forename: Hisao
authors.initials: H
authors.lastname: Yoshida
authors.affiliation: Division of Infection Control and Prevention, Osaka University Hospital, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Tomono
mesh_terms: D019115:Fasciitis, Necrotizing; D017809:Fatal Outcome; D006801:Humans; D007866:Leg / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D016868:Serratia Infections; D012706:Serratia marcescens; D018461:Soft Tissue Infections
keywords: Necrotizing fasciitis; Necrotizing soft tissue infection; Sepsis; Serratia marcescens