Morganella morganii infection in post-transplant kidney patient: Case Report and literature review

Abstract

Human infections by Morganella morganii are uncommon up to 3% of urinary tract infections, can produce various types of infections, its etiological role is doubtful. There are few reports worldwide in the literature on infections caused by this pathogen and none in Honduras. Description of Case. Male 46 years old with a history of renal transplantation 4 years ago for Chronic Kidney Disease, managed with prednisone, mycofelon and sirulimus, diabetic and chronic hypertension treated with NPH 20 u insulin. each day and Carvedilol 12.5 mg, referred to the Emergency room from the Nephrology service for having fever, one week of evolution, continuous, suggestively high, unquantified, diaphoresis with chills and dysuria of one day of evolution and one episode of vomiting. With vital signs PB 90/60 mmHg, CF 88 x’, RF 22 x’, afebrile, normal physical examination. Four hours after admission; began with fever of 38.9 ° C adding antipyretics to the established management, with hyponatremia, acute renal failure, pathological uroanalysis. Renal ultrasonography: Kidney transplanted thickened cortex corresponding to acute pyelonephritis, without masses, collections, lithium and hydronephrosis, measuring 12.7x5.8x4.9 cm. Uroculture: growth of Morganella morganii, resistant to fosfosil, nitrofurantoin, sensitive to ciprofloxacin and ceftazidime. Patient remained afebrile, improving the management established with ciprofloxacin IV is discharged on the fifth day after admission with strict follow-up by nephrology service. Conclusions. We report a pathology seen frequently, but in a special patient such as a renal transplant post that could bring multiple complications for the patient plus the pathogen is known as a urinary tract infection agent but rarely causes infections in immunocompetent persons, but if you can become a cause of nosocomial infection in immunocompromised people. We must follow strictly this type of patients from the slightest symptom to avoid sequels and / or severe complications.