Acquired Aplastic Anemia After Nosocomial Serratia marcescens Bone Marrow Infection in an Elderly Patient

Abstract

s u m m a r yA 76-year-old female patient with a multiple medical history developed refractory pancytopenia during treatment for peptic ulcer, bacteremia, pneumonia, and respiratory failure. Bone marrow biopsy revealed hypocellularity with few hematopoietic cells, which was indicative of aplastic anemia. Common causes including viral infection, mycobacterial infection, environmental exposure, congenital bone marrow disorder, and hematologic malignancy were primarily excluded. Identical Serratia marcescens cultures were isolated from the central venous catheter tip and bone marrow, and the pancytopenia improved gradually with proper antibiotics treatment. This case indicates that nosocomial S. marcescens infection may cause potentially fatal acquired aplastic anemia. Crucial issues in avoiding aplastic anemia include confronting increasing mortality and morbidity caused by nosocomial infection, improving environmental hygiene, early diagnosis of proper etiology, and adequate antibiotics treatment.