Elsevier

Human Pathology

Volume 13, Issue 5, May 1982, Pages 479-484
Human Pathology

Original contribution
Pathologic patternsof Serratia marcescens pneumonia**

https://doi.org/10.1016/S0046-8177(82)80031-2Get rights and content

To characterize the pulmonary lesions caused by Serratia marcescens, the authors reviewed all autopsy-culture-proven cases of S. marcescens pneumonia occurring at their hospital between 1968 and mid-1980. In 16, S. marcescens was the only organism cultured from the lungs during life or at autopsy. This report describes primarily these pure infections. Two histopathologic reactions were seen. Nine non-neutropenic patients had acute, hemorrhagic bronchopneumonia, seven with microabscesses and two with larger cavities. In seven, distinctive vasculitis was apparent in vessels larger than 75 microns in diameter; intramural gram-negative rods were identified in two. Seven immunosuppressed patients had diffuse neutropenic penumonitis resembling diffuse alveolar damage, with extensive intra-alveolar fibrinous exudates and pulmonary hemorrhage. In two patients, bacteria without cellular reaction were present. In patients with prolonged infections, focal areas of intra-alveolar organization and bronchiolitis obliterans accompanied both patterns. Since the incidence of nosocomial S. marcessens infection is increasing and since pneumonia caused by this organism is recognizable histologically, autopsy cultures positive for S. marcescens should not be disregarded.

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      Citation Excerpt :

      In 9 patients, the pathogens caused haemorrhagic bronchopneumonia, with micro-abscesses and cavitated lesions; vessels larger than 75 μm were also observed, due to the presence of vasculitis. In the remaining patients – represented by a population of 7 neutropenic cases – more extensive and diffuse pneumonia was found, sometimes resembling a diffuse alveolar damage lung pattern, with intra-alveolar fibrinous exudates and haemorrhage [10]. In our clinical case, the radiological appearance was similar to the morphological condition of a Serratia infection in non-neutropenic patients: no signs of diffuse alveolar damage were observed on CT images.

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    **

    This paper was presented at the Seventieth Annual Meeting of the US-Canadian Division of the International Academy of Pathology, Chicago, Ill, March 1981.

    *

    Research Fellow, Departments of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass.

    1

    Dr. Goldstein is supported in part by National Research Service Award 4-T32-HLO7066-05.

    Pathologist, Brigham and Women's Hospital, and Assistant Professor of Pathology, Harvard Medical School, Boston, Mass.

    Director, Division of Oncoradiology, Sidney Farber CancerInstitute, and Associate Professor of Radiology, Harvard Medical School, Boston, Mass.

    §

    Director, Division of Thoracic Radiology, Brigham andWomen's Hospital, and Professor of Radiology, Harvard Medical School, Boston, Mass.

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