Community-acquired cutaneous ulcer in a child caused by Serratia marcescens

INTRODUCTION Serratia marcescens is a Gram-negative, aerobic, motile bacillus belonging to the family Enterobacteriaceae. S. marcescens has been implicated in different types of infections including urinary tract infection, septicaemia, meningitis and wound infections. Very few cases of skin infections caused by this organism have been reported in the medical literature. S. marcescens is an important nosocomial pathogen but has rarely been implicated as a cause of community-acquired soft-tissue infections. CASE PRESENTATION We present a rare case of a community-acquired spontaneous cutaneous ulcer in an immunocompetent child from a sub-Himalayan region. Infections caused by S. marcescens may be difficult to treat because of its ability to produce a β-lactamase, which confers resistance to broad-spectrum, β-lactam antibiotics. CONCLUSION In our patient, the treatment was modified to ceftazidime and amikacin after sensitivity testing and the patient's condition improved. This necessitated isolation by culture and antimicrobial susceptibility testing to ensure appropriate therapy.