Serratia marcescens osteomyelitis in the hand of a non-debilitated, immunocompetent woman

Abstract

Serratia marcescens is an aerobic, gram-negative bacillus of the Enterobacteriaceae family that exists as a saprophyte in soil and environmental water sources. This bacterium colonizes the gastrointestinal, urinary, and respiratory tracts of humans and was long considered benign until the 1950s, when it was found to cause nosocomial infections in debilitated patients [1]. In the hospital setting, S. marcescens may contaminate saline bottles, intravenous solutions, hand lotions, and even disinfectants [1]. In debilitated and immunocompromised individuals, S. marcescens causes a wide variety of infections, including chronic osteomyelitis, septic arthritis, endocarditis, and meningitis [1–4]. In immunocompetent individuals, S. marcescens infections are uncommon and those involving the skin, soft tissue, and bone of the upper extremity are extremely rare. While acute osteomyelitis in the upper extremity has been observed in intravenous drug-abusing (IVDA) individuals, this condition has not been reported in healthy, non-IVDA individuals. Since S. marcescens is frequently multidrug-resistant, any infection with this bacterium is best treated with thirdor fourth-generation cephalosporins.