Case Report Serratia marcescens EndocarditiswithPerivalvularAbscess PresentingasAtrioventricularBlock AaronRichardson , 1 AndresMartinez, 2 ShreyaGhetiya, 1 EmilMissov, 1 RobertPercy, 1 andSrinivasanSattiraju 1 1 Division of Cardiology, University of Florida College of Medicine Jacksonville, Jacksonville, FL, USA 2 Department of Medicine, University of Florida College of Medicine Jacksonville, Jacksonville, FL, USA CorrespondenceshouldbeaddressedtoAaronRichardson;aaron.richardson@jax.ufl.edu Received 1 February 2020; Accepted 27 May 2020; Published 11 June 2020 AcademicEditor:GloriaTaliani Copyright©2020AaronRichardsonetal.isisanopenaccessarticledistributedundertheCreativeCommonsAttribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properlycited. Serratia marcescens is an aerobic, Gram-negative bacillus first identified in 1819 (Yeung et al. 2018). S. marcescens infective endocarditisisextremelyrareaccountingforonly0.14%ofallcases(PhadkeandJacob2016,Hadanoetal.2012,Nikolakopoulos etal.2019).Wepresentthecaseofa33-year-oldmalewithapastmedicalhistoryofHodgkinlymphoma,nonischemiccar- diomyopathyejectionfractionof25–30%,severeaorticstenosis,hepatitisC,andactiveintravenous(IV)drugabusewhowas admittedfollowingamotorvehicleaccident.Approximately10daysintohisadmission,hedevelopeda39.5degreeCelsiusfever, whichpromptedcollectionofbloodcultures.esecultureswerepositive(2outof2)for S. marcescens forwhichhewastreated withintravenouscefepime.Soonafterthisdiagnosis,patientdevelopedacompleteAVblock.Giventheinstabilityofthepatient, herequiredemergentplacementofatemporarypacingwire.Transesophagealechocardiogramwasorderedandrevealedanaortic root abscess. Given the comorbidities and active IV drug use, conservative management was pursued. Although rare, trends suggest that this pathogen may be on the rise. Further research is needed to better understand how to effectively manage this pathogen. 1.Introduction Serratia marcescens is an aerobic, motile, oxidase-negative, and Gram-negative bacillus first identified in 1819 [1]. S marcescens is an opportunistic pathogen associated with intravenous drug use, immunosuppression, previous an- tibiotic exposure, and indwelling catheterization. S. mar- cescens has a number of factors increasing virulence including fimbria-like adhesions, which allow for surface attachment and subsequent formation of biofilms in- creasing the likelihood of infection to humans. S. mar- cescens is most commonly known to cause urinary tract infections,pneumonia,andsofttissueinfections.Infective endocarditis by S. marcescens, first described in 1951, is extremely rare accounting for only 0.14% of all cases of endocarditis [2–4]. 2.CaseReport A 33-year-old male with a past medical history of Hodgkin lymphoma, nonischemic cardiomyopathy ejection fraction of 25–30%, severe aortic stenosis, hepatitis C, and intravenous drug abuse was admitted to the hospital following a motor vehicleaccident.Uponadmission,hewasfoundtohaveaclosed severelydisplacedzoneIIIsacralfractureforwhichconservative management was pursued due to patient's comorbidities. Approximately 3 days into the admission, he was di- agnosed with a urinary tract infection. Broad spectrum antibioticswereordered,andurineculturereturnedpositive for S. marcescens sensitivetociprofloxacin,gentamycin,and trimethoprim/sulfamethoxazole. Blood cultures drawn at thesametimetheurinarytractinfectionwasdiagnosedwere negative. e patient was treated with one week of Hindawi Case Reports in Infectious Diseases Volume 2020, Article ID 7463719, 5 pages https://doi.org/10.1155/2020/7463719