Serratia marcescens Lacrimal Canaliculitis

Introduction: Serratia marcescens is a motile, facultatively anaerobic gram-negative rod of the Enterobacteriaceae family and has been implicated mostly in contact lens related keratitis. We report a case of lacrimal duct canaliculitis seen in an elderly patient with no known risk factors for Serratia marcescens infection.

Presentation of Case: 74-year-old woman presented with loss of vision in the left eye and decreased vision, purulent discharge, swelling and itching of the right eye. Examination revealed nasal upper and lower lid swelling of the left eye with copious foul smelling, purulent discharge with yellowish concretions. On the basis of these findings, an assessment of lacrimal gland canaliculitis was made and a sample of the discharge sent for microbiology, culture and sensitivity revealed Serratia marcescens as the causative organism. The patient was placed on topical and oral antibiotics and response was good.

Conclusion: This case reveals that Serratia marcescens, although a rare cause of ocular infections, cannot be ruled out as a cause of lacrimal canaliculitis in patients with no known risk factor. This reinforces the fact that microbiology, culture and sensitivity should be done in all cases of lacrimal gland infections.