• CDC
  • Heart Failure
  • Cardiovascular Clinical Consult
  • Adult Immunization
  • Hepatic Disease
  • Rare Disorders
  • Pediatric Immunization
  • Implementing The Topcon Ocular Telehealth Platform
  • Weight Management
  • Monkeypox
  • Guidelines
  • Men's Health
  • Psychiatry
  • Allergy
  • Nutrition
  • Women's Health
  • Cardiology
  • Substance Use
  • Pediatrics
  • Kidney Disease
  • Genetics
  • Complimentary & Alternative Medicine
  • Dermatology
  • Endocrinology
  • Oral Medicine
  • Otorhinolaryngologic Diseases
  • Pain
  • Gastrointestinal Disorders
  • Geriatrics
  • Infection
  • Musculoskeletal Disorders
  • Obesity
  • Rheumatology
  • Technology
  • Cancer
  • Nephrology
  • Anemia
  • Neurology
  • Pulmonology

Serratia marcescens Pneumonia in an HIV-Infected Patient

Article

For 3 days, a 45-year-old woman with HIV infection who was noncompliant with her antiretroviral medications had cough, yellowish sputum, fever, and dyspnea. She denied hemoptysis, weight loss, or recent hospitalization. She had a long history of heavy smoking and alcohol and intravenous drug abuse.

For 3 days, a 45-year-old woman with HIV infection who was noncompliant with her antiretroviral medications had cough, yellowish sputum, fever, and dyspnea. She denied hemoptysis, weight loss, or recent hospitalization. She had a long history of heavy smoking and alcohol and intravenous drug abuse.

The patient had a high fever, tachycardia, tachypnea, and inspiratory rales in both lung fields but no evidence of hypoxia. White blood cell count was 23,500/μL, with 84% neutrophils. CD4+ cell count was 679/μL (well within the normal range). A chest radiograph revealed bibasilar patchy infiltrate (A).

Therapy with intravenous ceftriaxone and azithromycin was started for presumed community-acquired pneumonia, and the patient was isolated as a precaution. Her clinical condition did not improve with antibiotic and supportive treatment. No acidfast bacilli were isolated from sputum samples. A CT scan of the

chest showed extensive bilateral basilar pneumonitis (B). Multiple small cavities in both lungs were also noted. A subsequent bronchoscopy with lavage and bronchial washing isolated Serratia marcescens.

The patient responded well to intravenous imipenem. After 10 days, she was discharged.

The largest retrospective study of S marcescens infection in HIV patients (including 2398 cases) found documented S marcescens infection in only 0.71% of patients.1 All the affected patients were severely immunocompromised, with CD4+ cell counts of 70/μL or lower. An extensive literature review revealed that most of these infections (74% to 82%) were nosocomially acquired and were associated with a significantly high case-fatality rate (39% to 50%).2 Our case is unique because the infection was community-acquired and occurred in a patient with relatively preserved immune status.

References:

REFERENCES:


1.

Manfredi R, Nanetti A, Ferri M, Chiodo F. Clinical and microbiological surveyof Serratia marcescens infection during HIV disease.

Eur J Clin Microbiol InfectDis.

2000;19:248-253.

2.

Yu WL, Lin CW, Wang DY. Serratia marcescens bacteremia: clinical featuresand antimicrobial susceptibilities of the isolates.

J Microbiol Immunol Infect.

1998;31:171-179.

Related Videos
New Research Amplifies Impact of Social Determinants of Health on Cardiometabolic Measures Over Time
Tezepelumab Significantly Reduced Exacerbations in Patients with Severe Asthma, Respiratory Comorbidities
Overweight and Obesity: One Expert's 3 Wishes for the Future of Patient Care
Related Content
© 2024 MJH Life Sciences

All rights reserved.