Severe chronic osteomyelitis caused by Morganella morganii with high population diversity

• A case of severe chronic osteomyelitis caused by Morganella morganii and lasting for approximately 30 years is reported.
• The pathogen was identified through a combination of methods.
• Population structure analysis of isolates from this patient showed the bacterial population to be highly diverse.

SummaryA case of chronic osteomyelitis probably caused by Morganella morganii, occurring over a period of 30 years, is reported. The organism was identified through a combination of sample culture, direct sequencing, and 16S RNA gene amplicon sequencing. Further whole-genome sequencing and population structure analysis of the isolates from the patient showed the bacterial population to be highly diverse. This case provides a valuable example of a long-term infection caused by an opportunistic pathogen, M. morganii, with high diversity, which might evolve during replication within the host.