1887

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 . 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 should be considered in all cases of gas gangrene.

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2009-07-01
2019-10-18
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References

  1. Bagel, J. & Grossman, M. E. ( 1985; ). Hemorrhagic bullae associated with Morganella morganii septicemia. J Am Acad Dermatol 12, 575–576.[CrossRef]
    [Google Scholar]
  2. Bessman, A. N. & Wagner, W. ( 1975; ). Nonclostridial gas gangrene. Report of 48 cases and review of the literature. JAMA 233, 958–963.[CrossRef]
    [Google Scholar]
  3. Bird, D., Giddings, A. E. & Jones, S. M. ( 1977; ). Non-clostridial gas gangrene in the diabetic lower limb. Diabetologia 13, 373–376.[CrossRef]
    [Google Scholar]
  4. Brightmore, T. ( 1971; ). Non-clostridial gas infection. Proc R Soc Med 64, 1084–1085.
    [Google Scholar]
  5. Cafferkey, M. T., Buckley, T. F. & O'Morain, C. A. ( 1988; ). Association of reactive arthropathy and Morganella morganii cross reacting with Yersinia enterocolitica. Scand J Infect Dis 20, 439–442.[CrossRef]
    [Google Scholar]
  6. Chi, C. H., Chen, K. W., Huang, J. J., Chuang, Y. C. & Wu, M. H. ( 1995; ). Gas composition in Clostridium septicum gas gangrene. J Formos Med Assoc 94, 757–759.
    [Google Scholar]
  7. Choi, S. H., Lee, J. E., Park, S. J., Choi, S. H., Lee, S. O., Jeong, J. Y., Kim, M. N., Woo, J. H. & Kim, Y. S. ( 2008; ). Emergence of antibiotic resistance during therapy for infections caused by Enterobacteriaceae producing AmpC β-lactamase: implications for antibiotic use. Antimicrob Agents Chemother 52, 995–1000.[CrossRef]
    [Google Scholar]
  8. Cunningham, E. T., Jr, Whitcher, J. P. & Kim, R. Y. ( 1997; ). Morganella morganii postoperative endophthalmitis. Br J Ophthalmol 81, 170–171.
    [Google Scholar]
  9. Darke, S. G., King, A. M. & Slack, W. K. ( 1977; ). Gas gangrene and related infection: classification, clinical features and aetiology, management and mortality. A report of 88 cases. Br J Surg 64, 104–112.[CrossRef]
    [Google Scholar]
  10. Del Poso, J., Garcia-Silva, J., Almagro, M., Martinez, W., Nicolas, R. & Fonseca, E. ( 1998; ). Ecthyma gangrenosum-like eruption associated with Morganella morganii infection. Br J Dermatol 139, 520–521.[CrossRef]
    [Google Scholar]
  11. García Reinoso, C., Gómez Rubio, M., Sáez-Royela, F. & Melero Calleja, E. ( 1990; ). Fournier's disease: a report of 9 cases. Rev Esp Enferm Dig 78, 131–134 in Spanish.
    [Google Scholar]
  12. Hubens, G., Carly, B., De Boeck, H., Vansteenland, H. & Wylock, P. ( 1989; ). “Spontaneous” non clostridial gas gangrene: case report and review of the literature. Acta Chir Belg 89, 25–28.
    [Google Scholar]
  13. Isobe, H., Motomura, K., Kotou, K., Sakai, H., Satoh, M. & Nawata, H. ( 1994; ). Spontaneous bacterial empyema and peritonitis caused by Morganella morganii. J Clin Gastroenterol 18, 87–88.[CrossRef]
    [Google Scholar]
  14. Janda, J. M., Abbott, S. L., Khashe, S. & Robin, T. ( 1996; ). Biochemical investigations of biogroups and subspecies of Morganella morganii. J Clin Microbiol 34, 108–113.
    [Google Scholar]
  15. Kim, J. H., Cho, C. R., Um, T. H., Rhu, J. Y., Kim, E. S., Jeong, J. W. & Lee, H. R. ( 2007; ). Morganella morganii sepsis with massive hemolysis. J Korean Med Sci 22, 1082–1084.[CrossRef]
    [Google Scholar]
  16. Lee, I. K. & Liu, J. W. ( 2006; ). Clinical characteristics and risk factors for mortality in Morganella morganii bacteremia. J Microbiol Immunol Infect 39, 328–334.
    [Google Scholar]
  17. Mastroianni, A., Coronado, O. & Chiodo, F. ( 1994; ). Morganella morganii meningitis in a patient with AIDS. J Infect 29, 356–357.[CrossRef]
    [Google Scholar]
  18. McDermott, C. & Mylotte, J. M. ( 1984; ). Morganella morganii: epidemiology of bacteremic disease. Infect Control 5, 131–137.
    [Google Scholar]
  19. Owada, R., Kanamori, A., Hirai, N. & Yajima, Y. ( 1994; ). A case of NIDDM with non-clostridial gas-producing infection in the lower limb – the effects of hyperbaric oxygen therapy. Kansenshogaku Zasshi 68, 263–267 (in Japanese).[CrossRef]
    [Google Scholar]
  20. Setsuko, T., Masaaki, T. & Osamu, I. ( 2006; ). Two cases of non-clostridial gas gangrene developed from sacral pressure ulcer. Jpn J Press Ulcers 8, 188–194.
    [Google Scholar]
  21. Sica, S., Di Mario, A., Salutari, P., d'Onofrio, G., Antinori, A., Chiusolo, P. & Leone, G. ( 1995; ). Morganella morganii pericarditis after resolvent splenectomy for immune pancytopenia following allogeneic bone marrow transplantation for acute lymphoblastic leukemia. Clin Infect Dis 21, 1052–1053.[CrossRef]
    [Google Scholar]
  22. Styrt, B. & Gorbach, S. L. ( 1989; ). Recent developments in the understanding of the pathogenesis and treatment of anaerobic infections (2). N Engl J Med 321, 240–246.[CrossRef]
    [Google Scholar]
  23. Takahira, N., Shindo, M., Tanaka, K., Soma, K., Ohwada, T. & Itoman, M. ( 2002; ). Treatment outcome of nonclostridial gas gangrene at a level 1 trauma center. J Orthop Trauma 16, 12–17.[CrossRef]
    [Google Scholar]
  24. Yasuda, K., Hayashi, M., Takeda, N., Goshima, E. & Miura, K. ( 1986; ). A survived case of diabetic nonclostridial gas gangrene and the review of the literatures on microbiological findings. Jpn J Med 25, 171–174.[CrossRef]
    [Google Scholar]
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