J Med Cases

Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc

Journal website https://www.journalmc.org

Case Report

Volume 13, Number 3, March 2022, pages 99-103

Gemella morbillorum as the Culprit Organism of Post-Colonoscopy Necrotizing Perineal Soft Tissue Infection in a Diabetic Patient With Crohn’s Disease

Figure 1. A contrast-enhanced pelvic CT scan demonstrated left ischiorectal fossa infection with extra-luminal soft tissue gas (red circle and red arrow) concerning for a necrotizing soft tissue infection. No signs of rectal perforation or fistulous communication. CT: computed tomography.

**Table 1.** Summary of Characteristics of Reported Cases of Necrotizing Soft Tissue Infections Caused by G. morbillorum
Number	Authors, year	Age (years)/gender	Site of soft tissue infection	Possible risk factor(s)	Management, duration of antibiotics therapy, and isolated strains susceptibility
1	Romero-Velez et al, 2020 [14]	66 years/male	Necrotizing fasciitis of the upper back	Hypertension and atrial fibrillation	A combination of vancomycin, piperacillin-tazobactam, and clindamycin. Emergent debridement. The isolated strain was insensitive to most antibiotics. Transitioned to oral clindamycin to complete a 2-week course of antibiotics.
2	Ueberroth et al, 2019 [3]	30 years/male	Challenging pelvic abscess and perineal sepsis in the setting of unresectable perianal squamous cell carcinoma (SCC)	HIV infection; unresectable perianal SCC; status-post chemotherapy; active immunotherapy	Radiological guided drainage of the pelvic abscess. A combination of parenteral cefepime, vancomycin, and metronidazole for 18 days followed by oral metronidazole and ciprofloxacin for 6 weeks. No data available on the susceptibility of the isolated strain.
3	Bachmeyer et al, 2005 [13]	38 years/male	Necrotizing fasciitis of the right foot	Intravenous drug use; chronic hepatitis C infection	Initially treated with oxacillin and gentamycin. Emergency extensive debridement. The isolated strain was pan-sensitive but metronidazole.
4	Bachmeyer et al, 2005 [13]	39 years/male	Necrotizing fasciitis of right hand and arm	Intravenous drug use	Co-amoxiclav and gentamycin followed by oral amoxicillin. Emergent debridement. The isolated strain was pan-sensitive but metronidazole.
5	Rosina et al, 1999 [15]	24 years/male	Necrotizing infection of left arm and forearm	Trauma to the left hand with a fishing-hook	Abscess drainage. Erythromycin then teicoplanin and tobramycin. The isolated strain was pan-sensitive.

Table 1. Summary of Characteristics of Reported Cases of Necrotizing Soft Tissue Infections Caused by G. morbillorum

Number

Authors, year

Age (years)/gender

Site of soft tissue infection

Possible risk factor(s)

Management, duration of antibiotics therapy, and isolated strains susceptibility

Romero-Velez et al, 2020 [14]

66 years/male

Necrotizing fasciitis of the upper back

Hypertension and atrial fibrillation

A combination of vancomycin, piperacillin-tazobactam, and clindamycin. Emergent debridement. The isolated strain was insensitive to most antibiotics. Transitioned to oral clindamycin to complete a 2-week course of antibiotics.

Ueberroth et al, 2019 [3]

30 years/male

Challenging pelvic abscess and perineal sepsis in the setting of unresectable perianal squamous cell carcinoma (SCC)

HIV infection; unresectable perianal SCC; status-post chemotherapy; active immunotherapy

Radiological guided drainage of the pelvic abscess. A combination of parenteral cefepime, vancomycin, and metronidazole for 18 days followed by oral metronidazole and ciprofloxacin for 6 weeks. No data available on the susceptibility of the isolated strain.

Bachmeyer et al, 2005 [13]

38 years/male

Necrotizing fasciitis of the right foot

Intravenous drug use; chronic hepatitis C infection

Initially treated with oxacillin and gentamycin. Emergency extensive debridement. The isolated strain was pan-sensitive but metronidazole.

Bachmeyer et al, 2005 [13]

39 years/male

Necrotizing fasciitis of right hand and arm

Intravenous drug use

Co-amoxiclav and gentamycin followed by oral amoxicillin. Emergent debridement. The isolated strain was pan-sensitive but metronidazole.

Rosina et al, 1999 [15]

24 years/male

Necrotizing infection of left arm and forearm

Trauma to the left hand with a fishing-hook

Abscess drainage. Erythromycin then teicoplanin and tobramycin. The isolated strain was pan-sensitive.