Download PDF
CC BY-NC-ND 4.0 · AJP Rep 2021; 11(02): e113-e118
DOI: 10.1055/s-0041-1732407
Case Report

A Case of an Extremely Low Birth Weight Infant with Morganella morganii Bacteremia and Peritonitis

Betty Pham
1   Department of Pediatrics, University of California Irvine, Irvine, California
,
Anne Denslow
2   Neonatal-Perinatal Medicine Division, Children's Hospital of Orange County, Orange, California
,
Michel Mikhael 
2   Neonatal-Perinatal Medicine Division, Children's Hospital of Orange County, Orange, California
,
Jina Lim
2   Neonatal-Perinatal Medicine Division, Children's Hospital of Orange County, Orange, California
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

We describe a case of late onset Morganella morganii sepsis in an extremely low birth weight male neonate born at 23 and 4/7 weeks gestational age to a 30-year-old primigravid mother due to preterm labor. The mother was otherwise healthy with an unremarkable prenatal course. She received steroids and ampicillin prior to delivery. While initial blood cultures were negative, at day of life 4, the neonate developed signs of sepsis with leukocytosis and bandemia, and subsequent blood culture demonstrated growth of M. morganii. The patient then had spontaneous intestinal perforation on day of life 8 with peritoneal cultures growing M. morganii. The infant responded to standard therapy and survived to discharge, with few mild developmental delays upon outpatient follow-up. While M. morganii has been demonstrated in the neonatal population, it generally causes early onset sepsis and is associated with high mortality in preterm neonates. Here, we present this case of late onset neonatal sepsis with M. morganii complicated by spontaneous intestinal perforation, with survival in a 23 weeks gestation infant.

Keywords

Morganella morganii - spontaneous intestinal perforation - neonatal sepsis


Publication History

Received: 03 April 2021

Accepted: 07 June 2021

Article published online:
19 August 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Shane AL, Sánchez PJ, Stoll BJ. Neonatal sepsis. Lancet 2017; 390 (10104): 1770-1780
    CrossrefPubMedGoogle Scholar
  • 2 Stoll BJ, Hansen NI, Sánchez PJ. et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Early onset neonatal sepsis: the burden of group B Streptococcal and E. coli disease continues. Pediatrics 2011; 127 (05) 817-826
    CrossrefPubMedGoogle Scholar
  • 3 Salen PN, Eppes S. Morganella morganii: a newly reported, rare cause of neonatal sepsis. Acad Emerg Med 1997; 4 (07) 711-714
    CrossrefPubMedGoogle Scholar
  • 4 Stoll BJ, Hansen N, Fanaroff AA. et al. Late-onset sepsis in very low birth weight neonates: the experience of the NICHD Neonatal Research Network. Pediatrics 2002; 110 (2 Pt 1): 285-291
    CrossrefPubMedGoogle Scholar
  • 5 Erlanger D, Assous MV, Wiener-Well Y, Yinnon AM, Ben-Chetrit E. Clinical manifestations, risk factors and prognosis of patients with Morganella morganii sepsis. J Microbiol Immunol Infect 2019; 52 (03) 443-448
    CrossrefPubMedGoogle Scholar
  • 6 Liu H, Zhu J, Hu Q, Rao X. Morganella morganii, a non-negligent opportunistic pathogen. Int J Infect Dis 2016; 50: 10-17
    CrossrefPubMedGoogle Scholar
  • 7 Chang HY, Wang SM, Chiu NC, Chung HY, Wang HK. Neonatal Morganella morganii sepsis: a case report and review of the literature. Pediatr Int 2011; 53 (01) 121-123
    CrossrefPubMedGoogle Scholar
  • 8 Milligan KL, Barenkamp SJ. Neonatal meningitis due to Morganella morganii. Clin Pediatr (Phila) 2013; 52 (05) 462-464
    CrossrefPubMedGoogle Scholar
  • 9 Verboon-Maciolek M, Vandertop WP, Peters AC, Roord JJ, Geelen SP. Neonatal brain abscess caused by Morganella morganii. Clin Infect Dis 1995; 20 (02) 471
    CrossrefPubMedGoogle Scholar
  • 10 Morris M, Cleary JP, Soliman A. Small baby unit improves quality and outcomes in extremely low birth weight infants. Pediatrics 2015; 136 (04) e1007-e1015
    CrossrefPubMedGoogle Scholar
  • 11 Sinha AK, Kempley ST, Price E, Sharma BK, Livermore DM. Early onset Morganella morganii sepsis in a newborn infant with emergence of cephalosporin resistance caused by depression of AMPC beta-lactamase production. Pediatr Infect Dis J 2006; 25 (04) 376-377
    CrossrefPubMedGoogle Scholar
  • 12 Lee I-K, Liu JW. Clinical characteristics and risk factors for mortality in Morganella morganii bacteremia. J Microbiol Immunol Infect 2006; 39 (04) 328-334
    PubMedGoogle Scholar
  • 13 Boussemart T, Piet-Duroux S, Manouana M, Azi M, Perez JM, Port-Lis M. [Morganella morganii and early-onset neonatal infection]. Arch Pediatr 2004; 11 (01) 37-39
    CrossrefPubMedGoogle Scholar
  • 14 Casanova-Román M, Sanchez-Porto A, Casanova-Bellido M. Early-onset neonatal sepsis caused by vertical transmission of Morganella morganii. Scand J Infect Dis 2002; 34 (07) 534-535
    CrossrefPubMedGoogle Scholar
  • 15 Dessie SA, Dobariya V, Singh D, He P. A case of Morganella morganii-induced fetal demise. Cureus 2020; 12 (03) e7169
    PubMedGoogle Scholar
  • 16 Dutta S, Narang A. Early onset neonatal sepsis due to Morganella morganii. Indian Pediatr 2004; 41 (11) 1155-1157
    PubMedGoogle Scholar
  • 17 Johnson Jr JR, Feingold M. Case of chorioamnionitis in an immunocompetent woman caused by Morganella morganii. J Matern Fetal Med 1998; 7 (01) 13-14
    PubMedGoogle Scholar
  • 18 Maheshwari A, Dutta S, Kumar P, Narang A. Early onset mixed Morganella and Klebsiella sepsis in a neonate. Indian J Pediatr 2001; 68 (07) 671-672
    CrossrefPubMedGoogle Scholar
  • 19 Ovalle A, Martínez MA, Kakarieka E, García M, Salinas A. Sepsis neonatal precoz causada por transmisión vertical de Morganella morganii, en un embarazo de término [Fatal neonatal sepsis caused by vertical transmission of Morganella morganii. Report of one case.]. Rev Med Chil 2009; 137 (09) 1201-1204
    CrossrefPubMedGoogle Scholar
  • 20 Ranu SS, Valencia GB, Piecuch S. Fatal early onset infection in an extremely low birth weight infant due to Morganella morganii. J Perinatol 1999; 19 (07) 533-535
    CrossrefPubMedGoogle Scholar
  • 21 Rowen JL, Lopez SM. Morganella morganii early onset sepsis. Pediatr Infect Dis J 1998; 17 (12) 1176-1177
    CrossrefPubMedGoogle Scholar