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Purpose : To highlight and create awareness of the threat of Serratia marcescens, a relatively non virulent microorganism that causes devastating endophthalmitis in patients with indwelling catheters.
Methods : Case series
Results : Case 1: 52 years old gentleman, a known case of Diabetes Mellitus (DM), Hypertension, Ischaemic Heart Disease and End Stage Renal Failure (ESRF) on dialysis via permanent internal jugular catheter was diagnosed with endogenous endophthalmitis. He underwent right eye evisceration and recovered well from sepsis and pan ophthalmitis. Peripheral blood culture, internal jugular catheter tip and vitreous cultures all grew Serratia marcescens spp.
Case 2: A 67 years old lady with underlying DM and ESRF on dialysis via right internal jugular catheter was diagnosed with right eye endogenous endophthalmitis. Repeated intravitreal antibiotics were given. She recovered well following the injections. Blood culture and vitreous tap did not grow any organism. However, catheter tip sent for culture grew Serratia marcescens. A final diagnosis of presumed indwelling catheter related Serratia marcescens endogenous endophthalmitis was made.
Case 3: An 80 years old gentleman with history of cerebrovascular accident (CVA) and on permanent urinary catheter was referred for endogenous endophthalmitis of the left eye. Blood culture grew Serratia marcescens but no intravitreal injections to the eye was administered as he was unstable. The patient died from complications of urosepsis.
Conclusion : Despite being a known as a relatively non virulent microorganism, Serratia spp effects on the eye is devastating due to the presence of proteolytic enzymes. Indwelling catheter provides an ideal medium for Serratia to grow if not managed well. Regular indwelling catheter exchange and adherence to the protocol for management of indwelling catheters are the most important factors in preventing this condition
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