Fatal Morganella morganii bacteraemia in a diabetic patient with gas gangrene

Abstract

We report a case of a 60-year-old lady with a history of a heel ulcer that had not responded to antibiotic therapy. This progressed to involve the right leg, which was swollen and erythematous. Radiological imaging revealed the presence of gas within the fascial planes. Blood cultures on admission yielded Morganella morganii. Due to the extent of the gas gangrene and her comorbidities the patient was not suitable for surgical intervention and was treated conservatively with antibiotics. She deteriorated and died within 72 h of presentation. Non-clostridial gas gangrene is relatively rare, and diagnosis is frequently delayed and often missed. Early aggressive surgical intervention combined with appropriate antibiotic therapy is essential. Bacterial species other than Clostridium should be considered in all cases of gas gangrene.

Acute community-acquired meningoencephalitis with Morganella morganii – a case report / Meningoencefalită acută comunitară cu Morganella morganii – prezentare de caz

“…morganii species were more frequently isolated in urinary tract infections in elderly patients with long-term indwelling catheters, the wounds of diabetic patients with necrotizing fasciitis, patients with purulent peritonitis, chorioamniotitis, neonatal sepsis, pneumonia, otitis media, meningitis, brain abscess and in immunocompromised patients (2,13,14,15,16). We assume that in case of our patient, with terminal colorectal cancer and diabetes mellitus, an imbalance occurred in the saprophytic microflora which led to the dislocation of the bacteria, transient bacteremia and penetration into the CSF.…”

Foreign Body with Gas Gangrene in an Elderly Patient with Diabetes

“…In other reports of patients with diabetes and gas gangrene who were not considered surgical candidates due to multiple comorbidities, antibiotic treatment alone was inadequate in halting the spread of infection, leading to bacteremia and death [9]. Ultimately, a comprehensive diagnostic and radiographic evaluation in a patient with diabetes and asymmetric foot swelling may prevent the loss of limb and functional independence, especially in those at high-risk for physical disability such as the elderly [10].…”

<i>Morganella morganii</i> Peritonitis Associated with Continuous Ambulatory Peritoneal Dialysis (CAPD) after Colonoscopy

“…A cluster of M. morganii infections occurred at a general tertiary hospital in 2006 (2), consisting of 61% wound infections and 39% urinary tract infections. M. morganii has been reported as the cause of urinary tract infections (3), arthritis (4), pericarditis (5), pyomyositis (6), sepsis (7), chorioamnionitis (8), ecthyma gangrenosum-like eruptions (9), meningitis (10), renal abscesses (11), and gas gangrene (12) in neonates or elderly immunocompromised patients or those with other serious underlying diseases.…”