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.