Unpredictable Manifestation of Morganella Morganii Chorioamnionitis and Neonatal Demise - А Case Report

Morganella morganii, an opportunistic pathogen from the Enterobacteriaceae family, part of normal intestinal flora in humans, demonstrates a variety of virulent factors, as well as high antimicrobial resistance and mortality. In adults, Morganella morganii is associated with hospital-acquired infections, urinary tract infections in long-term catheter use, wound and hepatobiliary infections. It is not detected in normal vaginal flora and is rarely associated with obstetric infections. Chorioamnionitis is an inflammatory reaction of chorion and amnion resulting from ascending microbial invasion, although primary intrauterine inflammation has also been reported. This case report presents Morganella morganii chorioamnionitis in a 28-year-old woman, delivering by Cesarean section at 26+3 weeks of gestation, without detection of Morganella morganii in the genitourinary tract, so non-ascending pathogenesis was hypothesized. Neonatal demise occurred irrespective of appropriate therapy for bacteremia. Morganella morganii chorioamnionitis suggests vertical transmission. In the case presented here, the only risk factor - short-term catheterization, may have been responsible for Morganella morganii chorioamnionitis resulting from a possible genitourinary colonization with low bacterial load, leading to early-onset sepsis andneonatal demise. This clinically verifies the significant virulence of Morganella morganii, with its obstetric and neonatal complications unpredictable.