# Serratia marcescens as an Uncommon Cause of Infection Following Craniectomy: A Case Report and Literature Review

## TL;DR

This paper reports a rare case of Serratia marcescens causing a soft tissue infection after a craniectomy, highlighting the importance of aseptic practices in surgery.

## Contribution

The paper presents a rare clinical case of S. marcescens infection following craniectomy and emphasizes its atypical presentation.

## Key findings

- S. marcescens caused a soft tissue infection at the site of stored bone flaps after craniectomy.
- Culture and sensitivity tests were essential for targeted antibiotic therapy.
- The case underscores the need for strict aseptic procedures in handling surgical bone flaps.

## Abstract

Serratia marcescens (S. marcescens) is a common bacterial species isolated from patients’ specimens. Medical equipment like catheters, cannulas, tubing, dressing materials, and surgical instruments can become colonized by S. marcescens. Critically sick patients are the main victims, especially those in intensive care units or surgical settings where extended hospital stays and the use of broad-spectrum antibiotics are typical. Although S. marcescens is commonly linked to bloodstream infections, respiratory tract infections, and urinary tract infections, it is comparatively uncommon to be involved in wound infections following surgery. We describe a rare instance of a soft tissue infection brought on by S. marcescens at the location of the abdominal wall where autologous bone flaps were temporarily stored after a decompressive craniectomy. The patient had symptoms of a localized infection, which led to further evaluation and targeted therapy. Culture and antibiotic sensitivity tests guided the selection of drug therapy. This case demonstrates the unusual way that S. marcescens manifests in soft tissue infections following neurosurgery, emphasizing how crucial it is to follow strict aseptic procedures, particularly when working with surgical bone flaps. Knowledge of these atypical organisms is crucial for timely diagnosis and effective treatment, especially in critical care and postoperative settings.