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Lower-Extremity Infections Caused by Serratia marcescens

A Report of Three Cases and a Literature Review

Luis Marin Department of Podiatry, Palmetto General Hospital, Hialeah, FL. Dr. Rowan is now with the Department of Foot and Ankle Surgery, Bethesda Health, Boynton Beach, FL and David L. Smythe Wound Care Center, Martin Health System, Stuart, FL. Dr. Mantilla is now with the Ankle and Foot Centeres of Tampa Bay, Tampa, FL. Dr. Olupona is now with the Coral Gables Podiatry Center, Miami, FL.

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Raymond Rowan Department of Podiatry, Certified Foot and Ankle Specialists, Palm City, FL. Dr. Rowan is now with the Department of Podiatry, Palmetto General Hospital, Hialeah, FL.

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Ana Mantilla Department of Podiatry, Palmetto General Hospital, Hialeah, FL. Dr. Rowan is now with the Department of Foot and Ankle Surgery, Bethesda Health, Boynton Beach, FL and David L. Smythe Wound Care Center, Martin Health System, Stuart, FL. Dr. Mantilla is now with the Ankle and Foot Centeres of Tampa Bay, Tampa, FL. Dr. Olupona is now with the Coral Gables Podiatry Center, Miami, FL.

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Bamidele Olupona Department of Podiatry, Palmetto General Hospital, Hialeah, FL. Dr. Rowan is now with the Department of Foot and Ankle Surgery, Bethesda Health, Boynton Beach, FL and David L. Smythe Wound Care Center, Martin Health System, Stuart, FL. Dr. Mantilla is now with the Ankle and Foot Centeres of Tampa Bay, Tampa, FL. Dr. Olupona is now with the Coral Gables Podiatry Center, Miami, FL.

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Ann MacIntyre Department of Infectious Diseases, Palmetto General Hospital, Hialeah, FL.

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Serratia marcescens is a ubiquitous, facultatively anaerobic, gram-negative bacillus that has been cited to cause infection in immunocompromised populations. In the literature, S marcescens infections of the lower extremity have presented as granulomatous ulceration, abscess, bullous cellulitis, and necrotizing fasciitis. Herein we present a series of three cases of lower-extremity infections in which S marcescens was the sole or a contributing pathogen. We discuss the commonalities of these three cases as well as with those previously cited. All three patients presented with some combination of a similar set of clinical characteristics, including bullae formation, liquefactive necrosis, and black necrotic eschar. All three patients were diabetic and had peripheral vascular disease.

Corresponding author: Raymond Rowan, DPM, MS, Department of Podiatry, Certified Foot & Ankle Specialists, 2664 SW Immanuel Dr, Palm City, FL 34990. (E-mail: DrRRowan@yahoo.com)
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