Community Acquired Meningitis from Serratia Marcescens in an Adult: A Case Report (2480)

Objective: To describe the first case of spontaneous Serratia marcescens monoinfection in CSF in an adult with intravenous drug abuse. Background: Gram negative rods are an uncommon cause for meningitis. A rise in nosocomial gram negative bacillary meningitis has been observed. Serratia is a described pathogen for acute cerebrospinal fluid (CSF) infections in neonates and iatrogenic cases. Design/Methods: NA Results: We report this case of a 53 year old male with active intravenous drug use (IVDU) and no previous neurosurgical procedures, who presented with altered mental status and gait instability for 2 weeks along with headache, nausea and vomiting for 2 months. CT scan revealed hydrocephalus requiring urgent placement of an intraventricular catheter. Initial CSF analysis revealed glucose of Conclusions: Serratia marcescens is an extremely rare cause of acute meningitis in adults and reported cases have a history of cranial, spinal or otic manipulation. On the contrary, our patient had an insidious onset of meningitis resulting in hydrocephalus with no prior procedures. His IVDU was likely a risk factor, though there was no evidence of bacteremia. Atypical organisms in CSF can often be disregarded as contaminants. This can delay therapy and increase morbidity and mortality. Our case highlights an atypical presentation of meningitis caused by a rare organism. Disclosure: Dr. Humayun has nothing to disclose. Dr. Agnihotri has nothing to disclose.