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Fatal Morganella morganii bacteraemia in a diabetic patient with gas gangrene

¹ Department of Diabetes and Endocrinology, Ayr Hospital, NHS Ayrshire and Arran, Ayr KA6 6DX, Scotland, UK

² Department of Medical Microbiology, Ayr Hospital, NHS Ayrshire and Arran, Ayr KA6 6DX, Scotland, UK

Correspondence
Sujoy Ghosh
drsujoyghosh{at}rediffmail.com

Received December 17, 2008
Accepted March 16, 2009

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 co-morbidities 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.