Serratia marcescens is a Gram-negative bacillus belonging to the Enterobacteriaceae family. Cutaneous infection with Serratia is rare, and usually occurs in immunocompromised individuals. Primary cutaneous infections are uncommon, but they are typically severe and are associated with significant morbidity and mortality. The pathogenetic factors leading to S. marcescens infection are not fully understood, but contributing virulence factors include proteases, secreted exotoxins, and the formation of biofilm. We report a case of cellulitis occurring in a splenectomized patient, which led to multiple wound debridements and a transmetatarsal amputation. This dramatic case led us to review the published literature on soft tissue infections caused by S. marcescens.

Fusarium is a filamentous fungi that has emerged as a frequent cause of invasive infections in immunocompromised patients. Dermatologists often play a critical role in diagnosing fusariosis, as greater than 70% of patients with disseminated infections have cutaneous involvement, and microbiologic evaluation of skin specimens provides the diagnosis in the majority of cases. Second-generation triazoles are typically the most effective medications in treating invasive Fusarium infections, and we discuss the benefits of using these medications, as well as detail the side effects of these therapeutic agents.

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