Myroides odoratimimus-Associated Skin and Soft Tissue Infection in Critical Limb Ischemia With Progressive Gangrene:...

Myroides species are rare but increasingly recognized opportunistic pathogens, primarily affecting immunocompromised individuals and those with environmental or nosocomial exposures. These organisms exhibit intrinsic multidrug resistance, making infections difficult to treat. We report a case of a 59-year-old woman with poorly controlled diabetes mellitus who presented with progressively worsening bilateral foot ulcers in the context of newly diagnosed severe peripheral arterial disease. Her history was notable for saltwater exposure in Acapulco, Mexico, and multiple prior hospital encounters. Wound cultures grew Myroides odoratimimus exhibiting high-level antimicrobial resistance. Despite broad-spectrum intravenous antibiotics and attempted revascularization, her infection and ischemia progressed, necessitating a below-knee amputation. This case underscores the emerging clinical relevance of M. odoratimimus as an environmental pathogen capable of causing destructive soft-tissue infections in patients with chronic comorbidities. It highlights the importance of early culture-guided antimicrobial therapy, recognition of potential environmental exposure sources, and prompt surgical intervention for infection control and limb salvage.