Skip to main content
SpringerLink
Log in

Skin ulcers caused by Serratia marcescens: three cases and a review of the literature

  • Clinical report
  • Published:
European Journal of Dermatology

Abstract

Background

Serratia marcescens is a Gram-negative, encapsulated, motile, anaerobic, non-sporulating bacillus that belongs to the Enterobacteriaceae family. It is found in water, soil, plants, food, and garbage. S. marcescens is an opportunistic pathogen. It usually causes nosocomial infections, such as lung and genitourinary infections, sinusitis, otitis, endocarditis, and sepsis. Skin infections caused by S. marcescens are rare.

Objectives

To describe three new cases of skin ulcers of the leg caused by S. marcescens and review the relevant literature.

Materials & methods

We investigated three patients admitted for ulcers on the leg.

Results

In two patients, post-traumatic aetiology was concluded. The modality of infection was not identified for the other patient. One patient was diabetic. All patients recovered with specific antibiotic therapy (ciprofloxacin, ceftriaxone and levofloxacin, respectively).

Conclusion

Skin ulcers due to S. marcescens are very rare. The three cases presented here add to the limited literature of skin infections caused by S. marcescens.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Epstein E, Carson TE. Serratia granuloma. JAMA 1973; 223: 670–1.

    Article  CAS  PubMed  Google Scholar 

  2. Epstein E, Carson TE. Serratia granuloma. Fortschr Med 1973; 91: 1287–8.

    CAS  PubMed  Google Scholar 

  3. Stamm WE, Kolff CA, Dones EM, et al. A nursery outbreak caused by Serratia marcescens- scalp-vein needles as a portal of entry. J Pediatr 1976; 89: 96–9.

    Article  CAS  PubMed  Google Scholar 

  4. Brenner DE, Lookingbill DP. Serratia marcescens cellulitis. Arch Dermatol 1977; 113: 1599–600.

    Article  CAS  PubMed  Google Scholar 

  5. Bonner MJ, Meharg JG Jr.. Primary cellulitis due to Serratia marcescens. JAMA 1983; 250: 2348–9.

    Article  CAS  PubMed  Google Scholar 

  6. Rimailho A, Riou B, Richard C, Auzepy P. Fulminant necrotizing fasciitis and nonsteroidal anti-inflammatory drugs. J Infect Dis 1987; 155: 143–6.

    Article  CAS  PubMed  Google Scholar 

  7. Kaplan H, Sehtman L, Ricover N, Slatkis D, Lacentre E. Serratia marcescens. Afecciones cutáneas. Informe preliminar. Med Cutan Ibero Lat Am 1988; 16: 305–8.

    CAS  PubMed  Google Scholar 

  8. Bogaert MA, Hogan DJ, Miller AE Jr.. Serratia cellulitis and secondary infection of leg ulcers by Serratia. J Am Acad Dermatol 1991; 25: 565.

    Article  CAS  PubMed  Google Scholar 

  9. Bornstein PF, Ditto AM, Noskin GA. Serratia marcescens cellulitis in a patient on hemodialysis. Am J Nephrol 1992; 12: 374–6.

    Article  CAS  PubMed  Google Scholar 

  10. Zipper RP, Bustamante MA, Khatib R. Serratia marcescens: a single pathogen in necrotizing fasciitis. Clin Infect Dis 1996; 23: 648–9.

    Article  CAS  PubMed  Google Scholar 

  11. Mu˜noz-Pérez MA, Rodriguez-Pichardo A, Camacho F. Disseminated papular eruption caused by Serratia marcescens: a new cutaneous manifestation in HIV-positive patients. AIDS 1996; 10: 1179–80.

    Google Scholar 

  12. Yanagi T, Katagiri K, Sonoda T, Takayasu S. Serratia marcescens granuloma. Br J Dermatol 1997; 136: 289–90.

    Article  CAS  PubMed  Google Scholar 

  13. Pereira JA, Greig JR, Liddy H, Ion L, Moss ALH. Leech-borne Serratia marcescens infection following complex hand injury. Br J Plast Surg 1998; 51: 640–1.

    Article  CAS  PubMed  Google Scholar 

  14. Cooper CL, Wiseman M, Brunham R. Bullous cellulitis caused by Serratia marcescens. Int J Infect Dis 1998; 3: 36–8.

    Article  CAS  PubMed  Google Scholar 

  15. Hsieh S, Babl FE. Serratia marcescens cellulitis following an iguana bite. Clin Infect Dis 1999; 28: 1181–2.

    Article  CAS  PubMed  Google Scholar 

  16. Nieves DS, James WD. Painful red nodules of the legs: a manifestation of chronic infection with Gram-negative organisms. J Am Acad Dermatol 1999; 41: 319–21.

    Article  CAS  PubMed  Google Scholar 

  17. Marzano AV, Gasparini G, Caputo R. Cutaneous infection caused by Serratia marcescens. Cutis 2000; 66: 461–3.

    CAS  PubMed  Google Scholar 

  18. Liangpunsakul S, Pursell K. Community-acquired necrotizing fasciitis caused by Serratia marcescens: case report and review. Eur J Clin Microbiol Infect Dis 2001; 20: 509–10.

    Article  CAS  PubMed  Google Scholar 

  19. Newton CL, de Lemos D, Abramo TJ, Murrey A, Noell C. Cervical necrotizing fasciitis caused by Serratia marcescens in a 2 year old. Pediatr Emerg Care 2002; 18: 433–5.

    Article  PubMed  Google Scholar 

  20. Friedman ND, Peterson NB, Sumner WT, Alexander BD. Spontaneous dermal abscesses and ulcers as a result of Serratia marcescens. J Am Acad Dermatol 2003; 49: S193–4.

    Article  PubMed  Google Scholar 

  21. Bachmeyer C, Sanguina M, Turc Y, Reynaert G, Blum L. Necrotizing fasciitis due to Serratia marcescens. Clin Exp Dermatol 2004; 29: 673–4.

    Article  CAS  PubMed  Google Scholar 

  22. Dissemond J, Schmid EN, Esser S, Witthoff M, Goos M. Bakterielle Kolonisation chronischer Wunden. Hautarzt 2004; 55: 280–8.

    Article  CAS  PubMed  Google Scholar 

  23. Curtis CE, Chock S, Henderson T, Holman MJ. A fatal case of necrotizing fasciitis caused by Serratia marcescens. Am Surg 2005; 71: 228–30.

    PubMed  Google Scholar 

  24. Rodríguez García FR, Paz RC, González RS, et al. Cutaneous infection caused by Serratia marcescens in a child. J Am Acad Dermatol 2006; 55: 357–8.

    Article  Google Scholar 

  25. João AM, Serrano PN, Cachão MP, Bártolo EA, Brandão FM. Recurrent Serratia marcescens cutaneous infection manifesting as painful nodules and ulcers. J Am Acad Dermatol 2008; 58: S55–7.

    Article  PubMed  Google Scholar 

  26. Rallis E, Karanikola E, Papadakis P. Severe facial infection caused by Serratia marcescens in an immunocompetent soldier. J Am Acad Dermatol 2008; 58: S109–10.

    Article  PubMed  Google Scholar 

  27. Soria X, Bielsa I, Ribera M, et al. Acute dermal abscesses caused by Serratia marcescens. J Am Acad Dermatol 2008; 58: 891–3.

    Article  PubMed  Google Scholar 

  28. Langrock ML, Linde HJ, Landthaler M, Karrer S. Leg ulcers and abscesses caused by Serratia marcescens. Eur J Dermatol 2008; 18: 705–7.

    PubMed  Google Scholar 

  29. Rodríguez RB, Rodríguez EB, Azuara BO. Fascitis necrosante extrahospitalaria por Serratia marcescens. Med Clin 2008; 130: 198–9.

    Article  Google Scholar 

  30. Friend JC, Hilligoss DM, Marquesen M, et al. Skin ulcers and disseminated abscesses are characteristic of Serratia marcescens infection in older patients with chronic granulomatous disease. J Allergy Clin Immunol 2009; 124: 164–6.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Yoshida R, Takae Y, Fujio Y, Tanaka M, Ohyama M. Cutaneous Serratia marcescens infection on the face of a healthy female. J Eur Acad Dermatol Venereol 2009; 23: 1213–5.

    Article  CAS  PubMed  Google Scholar 

  32. Grim KD, Doherty C, Rosen T. Serratia marcescens bullous cellulitis after iguana bites. J Am Acad Dermatol 2010; 62: 1075–6.

    Article  PubMed  Google Scholar 

  33. Im SK, Yoon KC. Corneal perforation with preseptal cellulitis in a patient with acute lymphocytic leukemia. J Korean Med Sci 2010; 25: 1251–2.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Madani TA, Alsaedi S, James L, et al. Serratia marcescenscontaminated baby shampoo causing an outbreak among newborns at King Abdulaziz University Hospital, Jeddah. Saudi Arabia. J Hosp Inf 2011; 78: 16–9.

    Article  CAS  Google Scholar 

  35. Giráldez P, Mayo E, Pavón P, Losada A. Skin infection due to Serratia marcescens in an immunocompetent patient. Actas Dermosifiliogr 2011; 102: 236–7.

    Article  PubMed  Google Scholar 

  36. Motsitsi NS. Fatal necrotizing fasciitis following human bite of the forearm. J Hand Surg Eur 2011; 36: 605.

    Article  CAS  Google Scholar 

  37. Rehman T, Moore TA, Seoane L. Serratia marcescens necrotizing fasciitis presenting as bilateral breast necrosis. J Clin Microbiol 2012; 50: 3406–8.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Prelog T, Jereb M, Cuˇcek I, Jazbec J. Necrotizing fasciitis caused by Serratia marcescens after venous access port implantation in a child with acute lymphoblastic leukemia. J Pediatr Hematol Oncol 2012; 34: e246–8.

    Article  Google Scholar 

  39. Wen YK. Necrotizing fasciitis caused by Serratia marcescens: a fatal complication of nephrotic syndrome. Ren Fail 2012; 34: 649–52.

    Article  PubMed  Google Scholar 

  40. Park KY, Seo SJ. Cutaneous Serratia marcescens infection in an immunocompetent patient after filler injection. Acta Derm Venereol 2013; 93: 191–2.

    Article  PubMed  Google Scholar 

  41. Subramani P, Narasimhamurthy GB, Ashokan B, Madappa BP. Serratia marcescens: an unusual pathogen associated with snakebite cellulitis. J Infect Dev Ctries 2013; 7: 152–4.

    Article  PubMed  Google Scholar 

  42. Vano-Galvan S, Álvarez-Twose I, Moreno-Martín P, Jaén P. Fulminant necrotizing fasciitis caused by Serratia marcescens in an immunosuppressed host. Int J Dermatol 2014; 53: e57–8.

    Article  Google Scholar 

  43. Carlesimo M, Pennica A, Muscianese M, et al. Multiple skin ulcers due to Serratia marcescens in a immunocompetent patient. G Ital Dermatol Venereol 2014; 149: 367–70.

    CAS  PubMed  Google Scholar 

  44. Lakhani NA, Narsinghani U, Kumar R. Necrotizing fasciitis of the abdominal wall caused by Serratia marcescens. Infect Dis Rep 2015; 7: 15–8.

    Article  Google Scholar 

  45. Seo J, Shin D, Oh SH, et al. Cutaneous Serratia marcescens infections in Korea: a retrospective analysis of 13 patients. J Dermatol 2016; 43: 149–55.

    Article  CAS  PubMed  Google Scholar 

  46. Diranzo García J, Villodre Jiménez J, Zarzuela Sánchez V, Castillo Ruiperez L, Bru Pomer A. Skin abscess due to Serratia marcescens in an immunocompetent patient after receiving a tattoo. Case Rep Infect Dis 2015; 2015: 626917.

    PubMed  PubMed Central  Google Scholar 

  47. Majumdar R, Crum-Cianflone NF. Necrotizing fasciitis due to Serratia marcescens: case report and review of the literature. Infection 2016; 44: 371–7.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Via Pace, 9-20122, Milan, Italy

    Stefano Veraldi & Gianluca Nazzaro

Authors
  1. Stefano Veraldi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gianluca Nazzaro
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stefano Veraldi.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Veraldi, S., Nazzaro, G. Skin ulcers caused by Serratia marcescens: three cases and a review of the literature. Eur J Dermatol 26, 373–376 (2016). https://doi.org/10.1684/ejd.2016.2777

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1684/ejd.2016.2777

Key words

Search

Navigation