Infection of finger caused by Morganella morganii leading to digital amputation: A case report

Medicine (Baltimore). 2019 Jan;98(2):e14002. doi: 10.1097/MD.0000000000014002.

Abstract

Rationale: Digital infection is a common disease in clinic, featured by pain and swelling of digits. As far as we know, no article has reported a case of digital infected by Morganella morganii.

Patient concerns: A 58-year-old Chinese female complains about whitlow with pain and swelling for 2 weeks. She has a history of diabetes for 10 years. She received incision and drainage before coming to our hospital and preoperative X-ray of left ring finger presented no bone eroded.

Diagnosis: She is diagnosed with infection of ring finger caused by M morganii in our hospital.

Interventions: We perform aggressive operative debridement and drainage firstly. Meanwhile, we provide tissue samples for diagnosis and the result indicates M morganii infection. Then, she is treated with anti-infection therapy and regulation of diabetes. However, 1 week after first surgery, her condition deteriorate presenting bone erosion in distal phalanx of ring finger from X-ray. Considering severity of illness, we decide to perform digital amputation.

Outcomes: At 3-month follow-up, the patient has a satisfactory result and X-ray shows no bone eroded.

Lessons: Clinicians should consider M morganii, which is rare in hand infection, as a cause of digital infection. This case reminds us that some whitlow is dangerous, amputation should be considered if necessary.

Publication types

  • Case Reports

MeSH terms

  • Amputation, Surgical / methods*
  • Enterobacteriaceae Infections / microbiology*
  • Enterobacteriaceae Infections / surgery*
  • Female
  • Fingers / microbiology*
  • Humans
  • Middle Aged
  • Morganella morganii / isolation & purification*