A brief preface to the case from the author: Like many Navy physicians, even though I was a subspecialist in adolescent medicine, I had call or was asked to help out several times a month in the pediatric acute care clinic (PACC). I did not mind that much as I had been a general pediatrician for 13 years when I finally decided to do my subspecialty. I wavered between pediatric dermatology and adolescent medicine, but adolescent medicine finally won out.
I trained at a time when we did much of our own lab work, including microbiology, and I had become quite adept in that field of study. I felt this provided me with a more holistic approach to solving medical mysteries.
The case you'll follow above, I think, will prove my point. Resources are below, but read the case to the end, first.
Mahlen SD. Serratia infections: from military experiments to current practice. Clin Microbiol Rev. 2011;24:755- 791.
Yu VL. Serratia marcescens-historical perspective and clinical review. N Engl J Med. 1979; 300:887-893.
For additional reading please see references cited in the case "A Tale of Two Urines."