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Peer-reviewedCC BYCase reports in infectious diseases

Serratia Causing Liver Abscess in a Young Immunocompetent Female: A Rare Case With Literature Review.

  • Malak R Hroub1
  • Mohammed A Barakat2
  • Alhareth M Amro1
  • Mohanad A Abuzahra3
  • Maha Ramzi4
  • Omar H Salloum5
  • Basheer Babaa1
5 affiliations
  1. 1Faculty of Medicine Al-Quds University Jerusalem West Bank State of Palestine alquds.edu.
  2. 2Department of Radiology Rafidia Hospital Nablus West Bank State of Palestine.
  3. 3Department of Radiology Istishari Arab Hospital Ramallah West Bank State of Palestine.
  4. 4Faculty of Health Professions Al-Quds University Jerusalem West Bank State of Palestine alquds.edu.
  5. 5Faculty of Medicine Palestine Polytechnic University Hebron West Bank State of Palestine ppu.edu.
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Abstract

Background

Pyogenic liver abscess (PLA) is a life-threatening condition predominantly caused by enteric Gram-negative bacilli in patients with diabetes, hepatobiliary disease, or immunosuppression. Serratia marcescens is a well-known opportunistic pathogen, typically causing nosocomial infections in compromised hosts. Community-acquired PLA due to S. marcescens in healthy individuals is exceedingly rare.Case presentation

A 28-year-old immunocompetent postpartum female presented with a 40-day history of low-grade fever following a cesarean section, accompanied by fatigue, lower abdominal discomfort, and recent right upper quadrant pain. Initial laboratory investigations revealed marked leukocytosis, microcytic anemia, thrombocytosis, and elevated C-reactive protein (318.76 mg/L). Abdominal computed tomography (CT) demonstrated an 8.5 × 5.8 cm multiloculated hypodense hepatic abscess in segment IV. CT-guided needle aspiration yielded purulent material; pus cultures selectively grew S. marcescens. Concurrently, extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Enterococcus faecalis were isolated from urine, while Staphylococcus haemolyticus grew in a single blood culture bottle. Target antimicrobial therapy was adjusted to intravenous meropenem, leading to rapid clinical and inflammatory marker improvement. Because the patient demonstrated prompt clinical stabilization following diagnostic aspiration, percutaneous catheter placement was deferred by a multidisciplinary team. She completed a course of IV meropenem followed by 4 weeks of oral trimethoprim-sulfamethoxazole. Follow-up ultrasound at 1 month confirmed clinical resolution and regression of the abscess cavity to 1.0 cm.Conclusion

S. marcescens should be considered in the differential diagnosis of PLA, even in immunocompetent individuals presenting with prolonged fever of unknown origin. Early cross-sectional imaging, microbiological aspiration, and multidisciplinary care are essential for prompt resolution without invasive surgical drainage.

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Cite

BibTeXRIS
BibTeX
@article{hroub2026serratia,
  title = {{Serratia Causing Liver Abscess in a Young Immunocompetent Female: A Rare Case With Literature Review.}},
  author = {Malak R Hroub and Mohammed A Barakat and Alhareth M Amro and Mohanad A Abuzahra and Maha Ramzi and Omar H Salloum and Basheer Babaa},
  journal = {Case reports in infectious diseases},
  year = {2026},
  month = oct,
  doi = {10.1155/crdi/7239044},
  url = {https://europepmc.org/article/MED/42923482},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Serratia Causing Liver Abscess in a Young Immunocompetent Female: A Rare Case With Literature Review.
AU  - Malak R Hroub
AU  - Mohammed A Barakat
AU  - Alhareth M Amro
AU  - Mohanad A Abuzahra
AU  - Maha Ramzi
AU  - Omar H Salloum
AU  - Basheer Babaa
PY  - 2026
DA  - 2026/10/21
JO  - Case reports in infectious diseases
DO  - 10.1155/crdi/7239044
UR  - https://europepmc.org/article/MED/42923482
AB  - Background  Pyogenic liver abscess (PLA) is a life-threatening condition predominantly caused by enteric Gram-negative bacilli in patients with diabetes, hepatobiliary disease, or immunosuppression. Serratia marcescens is a well-known opportunistic pathogen, typically causing nosocomial infections in compromised hosts. Community-acquired PLA due to S. marcescens in healthy individuals is exceedingly rare.Case presentation  A 28-year-old immunocompetent postpartum female presented with a 40-day history of low-grade fever following a cesarean section, accompanied by fatigue, lower abdominal discomfort, and recent right upper quadrant pain. Initial laboratory investigations revealed marked leukocytosis, microcytic anemia, thrombocytosis, and elevated C-reactive protein (318.76 mg/L). Abdominal computed tomography (CT) demonstrated an 8.5 × 5.8 cm multiloculated hypodense hepatic abscess in segment IV. CT-guided needle aspiration yielded purulent material; pus cultures selectively grew S. marcescens. Concurrently, extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Enterococcus faecalis were isolated from urine, while Staphylococcus haemolyticus grew in a single blood culture bottle. Target antimicrobial therapy was adjusted to intravenous meropenem, leading to rapid clinical and inflammatory marker improvement. Because the patient demonstrated prompt clinical stabilization following diagnostic aspiration, percutaneous catheter placement was deferred by a multidisciplinary team. She completed a course of IV meropenem followed by 4 weeks of oral trimethoprim-sulfamethoxazole. Follow-up ultrasound at 1 month confirmed clinical resolution and regression of the abscess cavity to 1.0 cm.Conclusion  S. marcescens should be considered in the differential diagnosis of PLA, even in immunocompetent individuals presenting with prolonged fever of unknown origin. Early cross-sectional imaging, microbiological aspiration, and multidisciplinary care are essential for prompt resolution without invasive surgical drainage.
SN  - 2090-6625
SN  - 2090-6633
ER  -