Morganella morganii Detected During Transfemoral Amputation in a Diabetic Foot With Soft Tissue Necrosis

This case report describes a 63-year-old man with diabetes mellitus and peripheral arterial disease who was referred to our clinic with circulatory insufficiency and a foul-smelling necrotizing wound of the right lower extremity.The patient had previously undergone bilateral balloon angioplasty, which restored distal pulses; however, progressive soft tissue deterioration led to extensive purulent ulcers along the anteromedial and posterior aspects of the lower leg.Imaging demonstrated subcutaneous gas in the posterior soft tissues, and transfemoral amputation was performed.During surgical dissection, purulent discharge was observed along the anteromedial aspect of the femur, and intraoperative samples were obtained for microbiological analysis.Cultures yielded Enterobacter species and Morganella morganii, the latter being an opportunistic Gram-negative bacillus that is rarely implicated in musculoskeletal infections.This case is notable for the uncommon identification of Morganella morganii in a deep musculoskeletal infection and emphasizes the importance of broad microbiological consideration in necrotizing soft tissue infections, particularly in patients with diabetes or other predisposing conditions.Timely surgical intervention, adequate source control, and culture-directed antimicrobial therapy remain essential in such complex clinical scenarios.