Serratia Marcescens, An Opportunistic Gram Negative Infection In Cardiac Valve Surgery

Abstract

<em>Serratia marcescens</em> (S.M) is a species of gram–negative bacteria in the family enterobacteriaceae. A human pathogen, <em>S. marcescens</em> is involved in nosocomial infections, particularly in urinary tract and wound infections. This report describes a 63 years-old man that referred to hospital with dyspnea FC IV and he underwent cardiac valves replacement surgery with a diagnosis of severe mitral stenosis (M.S), severe tricuspid regurgitation (T.R), and moderate aortic insufficiency (A.I). Five days after operation, he presented with 40 °C fever, respiratory distress, elevation of liver enzymes, and decreased consciousness. Sepsis work up showed positive blood culture for <em>Serratia marcescens</em>. Despite therapy, he died due to <em>Serratia marcescens</em> endocarditis and mediastinitis. Positive blood culture for <em>Serratia marcescens</em> is very rare but it should be considered in post operation patients after cardiac valve replacement presenting with fever. Besides, prevention of endocarditis due to <em>Serratia marcescens</em> should be observed.