title: Serratia marcescens Bullous Cellulitis in a Splenectomized Patient: A Case Report and Review of the Literature.
abstract: Serratia marcescens is a Gram-negative bacillus belonging to the Enterobacteriaceae family. Cutaneous infection with Serratia is rare, and usually occurs in immunocompromised individuals. Primary cutaneous infections are uncommon, but they are typically severe and are associated with significant morbidity and mortality. The pathogenetic factors leading to S. marcescens infection are not fully understood, but contributing virulence factors include proteases, secreted exotoxins, and the formation of biofilm. We report a case of cellulitis occurring in a splenectomized patient, which led to multiple wound debridements and a transmetatarsal amputation. This dramatic case led us to review the published literature on soft tissue infections caused by S. marcescens.
authors.affiliation: Department of Dermatology, Roger Williams Medical Center, Providence, RI, USA Department of Dermatology, Boston University School of Medicine, Boston, MA, USA johnbfournier@gmail.com.
authors.forename: John B
authors.initials: JB
authors.lastname: Fournier
authors.affiliation: Department of Dermatology, Roger Williams Medical Center, Providence, RI, USA.
authors.forename: Ganary
authors.initials: G
authors.lastname: Dabiri
authors.affiliation: Department of Medicine, Roger Williams Medical Center Providence, RI, USA.
authors.forename: Vinod
authors.initials: V
authors.lastname: Thomas
authors.affiliation: Department of Medicine, Roger Williams Medical Center Providence, RI, USA.
authors.forename: Gail
authors.initials: G
authors.lastname: Skowron
authors.affiliation: Department of Dermatology, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Polly
authors.initials: P
authors.lastname: Carson
authors.affiliation: Department of Biochemistry, Boston University, School of Medicine, Boston, MA, USA.
authors.forename: Vincent
authors.initials: V
authors.lastname: Falanga
mesh_terms: D000368:Aged; D000671:Amputation, Surgical / Q000379:methods*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001706:Biopsy / Q000379:methods; D002481:Cellulitis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D002939:Ciprofloxacin / Q000008:administration & dosage*; D003646:Debridement / Q000379:methods; D019115:Fasciitis, Necrotizing / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D005533:Foot Dermatoses / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D000077731:Meropenem; D016868:Serratia Infections / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D012706:Serratia marcescens / Q000302:isolation & purification*; D012872:Skin Diseases, Vesiculobullous / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D013156:Splenectomy / Q000009:adverse effects*; D013845:Thienamycins / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D002939:Ciprofloxacin; D000077731:Meropenem
keywords: Serratia marcescens; bullae; bullous cellulitis; lower extremity bullae; necrotizing fasciitis