Title : Cryptogenic brain abscess from Serratia marcescens in an immunocompetent patient: A case report and literature review
Abstract:
Although most bacterial brain abscesses are polymicrobial, growth of Serratia marcescens is rare in literature and reported only amongst paediatric populations and post-operative adults. Diagnosis is established through clinical history, imaging findings, and when possible, cultures. Treatment involves surgical resection / aspiration with an adequate culture-guided antibiotic regimen. Discussed is a case of a cryptogenic intracranial abscess with growth of S. marcescens in an immunocompetent, 33-year-old male. He was admitted for new-onset focal seizures. Imaging done showed masses along the left parietooccipital and frontal convexities for which drainage was performed on the 7th hospital day. Cultures yielded positive for growth of Serratia marcescens after 4 days. He was eventually discharged in stable condition on oral antibiotics. S. marcescens, albeit rare, is now a documented cause for intracranial abscess even amongst immunocompetent patients with no prior intracranial surgeries. This case report highlights the importance of early imaging and cultures of suspected abscesses with prompt management alongside surgical and infectious disease services to ensure best possible outcomes.
