Mario F. Pedero a 30-year-old male visited his physician complaining of painful bumps and soars on his leg. The patient was diagnosed with HIV + 5 years ago. Due to his diagnosis, cutaneous disorders may manifest from the condition itself, or it can lead to opportunistic infections or infections that are more extensive than normal.
The patient was sent to the emergency room were the physical examination revealed skin redness, papule lesions, and central ulcerations present on his left leg. A fever of 38.5 and general feeling of malaise. Systemic symptoms were not present at this time but blood cultures were collected anyway. Based on Mr. Pedero’s medical history a series of tests will be ordered …show more content…
marcescens are rare, usually occurring in elderly or immunocompromised individuals. Skin infections include granulomatous lesions, necrotizing fasciitis, nodules, cellulitis, dermal abscesses, leg ulcers, and disseminated papular eruption. In Fig-2 the lesions first appeared without any trauma to the leg or inflammatory signs in the skin (Alexandre 2008). With such a wide range of disease that S. marcescens may cause, there is not one determining symptom or source of origin. In fact, there are a variety of symptoms associated with S. marcescens that include sepsis, headache, infection, fever, chills, nausea, excessive sweating, vomiting, shock, malaise, joint pain convulsions, death, Bacteremia, UTI, Empyema, Lymphadenitis, Endocarditis, Meningitis Peritonitis, and Respiratory distress (Celine 2010-2014). In fig-2 the patient had a low grade fever 1 to two weeks before the skin lesions appeared, followed by the cutaneous nodules that rapidly evolved into ulcers (Alexandre …show more content…
marcescens naturally exhibits the capability to express antimicrobial resistance. Due to this ability of S. marcescens it is resistant to a wide range of antibiotics including narrow-spectrum-penicillins and cephalosporins, cefuroxime, cephamycins, macrolides, tetracycline, nitrofurantoin and colistin (Celine 2010-2014). Treatment is with 3rd-generation cephalosporins, cefepime, carbapenems, fluoroquinolones, piperacillin/tazobactam, or aminoglycosides. However, because some isolates are resistant to multiple antibiotics, susceptibility testing is essential (Bush 2014).
One recent study shows 50% of HIV/AIDS patients had severe sepsis at ICU admission or during the ICU stay. An astounding 90% of nosocomial infections were the source of sepsis and the microbiology of infections was mostly gram-negative rods Serratia marcescens (three) made up 7% (Japiassú