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2026, Vol: 16, Issue: 3
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Title Page

Case Report


A rare case of Citrobacter youngae co-infection in a diabetic foot ulcer: Importance of deep tissue culture in a Tertiary Care Hospital

Arokiamary Ramaraj, Karthika Jayakumar, Jaison Jayakaran, Sandeep Kadali.


Abstract
Background:
Diabetic foot infections (DFIs) are often polymicrobial and require accurate microbiological diagnosis for effective management. Superficial cultures may fail to detect deeper pathogens, leading to inadequate therapy. This study aims to highlight the role of deep tissue culture in identifying uncommon pathogens.

Case Description:
We report a single case study of an 82-year-old male with long-standing diabetes mellitus presenting with a non-healing left foot ulcer following a thorn prick injury. Initial pus culture yielded Klebsiella pneumoniae, and empirical therapy failed to produce clinical improvement. Deep tissue culture obtained during surgical debridement revealed polymicrobial infection with Klebsiella pneumoniae and Citrobacter youngae. Identification was confirmed using the VITEK 2 automated system. Antibiotic therapy was modified based on susceptibility testing, resulting in significant clinical recovery.

Conclusion:
This case emphasizes that deep tissue sampling is crucial in non-responding DFIs for accurate pathogen identification and targeted therapy. Detection of rare organisms such as C. youngae can significantly alter clinical management and improve outcomes.

Key words: Antimicrobial susceptibility; Citrobacter youngae; Deep tissue culture; Diabetic foot ulcer; Vitek identification.


 
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How to Cite this Article
Pubmed Style

Ramaraj A, Jayakumar K, Jayakaran J, Kadali S. A rare case of Citrobacter youngae co-infection in a diabetic foot ulcer: Importance of deep tissue culture in a Tertiary Care Hospital. J Microbiol Infect Dis. 2026; 16(3): 145-149. doi:10.5455/JMID.2026.v16.i3.2

Web Style

Ramaraj A, Jayakumar K, Jayakaran J, Kadali S. A rare case of Citrobacter youngae co-infection in a diabetic foot ulcer: Importance of deep tissue culture in a Tertiary Care Hospital. https://www.jmidonline.org/?mno=309972 [Access: July 08, 2026]. doi:10.5455/JMID.2026.v16.i3.2

AMA (American Medical Association) Style

Ramaraj A, Jayakumar K, Jayakaran J, Kadali S. A rare case of Citrobacter youngae co-infection in a diabetic foot ulcer: Importance of deep tissue culture in a Tertiary Care Hospital. J Microbiol Infect Dis. 2026; 16(3): 145-149. doi:10.5455/JMID.2026.v16.i3.2


Vancouver/ICMJE Style

Ramaraj A, Jayakumar K, Jayakaran J, Kadali S. A rare case of Citrobacter youngae co-infection in a diabetic foot ulcer: Importance of deep tissue culture in a Tertiary Care Hospital. J Microbiol Infect Dis. (2026), [cited July 08, 2026]; 16(3): 145-149. doi:10.5455/JMID.2026.v16.i3.2


Harvard Style

Ramaraj, A., Jayakumar, . K., Jayakaran, . J. & Kadali, . S. (2026) A rare case of Citrobacter youngae co-infection in a diabetic foot ulcer: Importance of deep tissue culture in a Tertiary Care Hospital. J Microbiol Infect Dis, 16 (3), 145-149. doi:10.5455/JMID.2026.v16.i3.2


Turabian Style

Ramaraj, Arokiamary, Karthika Jayakumar, Jaison Jayakaran, and Sandeep Kadali. 2026. A rare case of Citrobacter youngae co-infection in a diabetic foot ulcer: Importance of deep tissue culture in a Tertiary Care Hospital. Journal of Microbiology and Infectious Diseases, 16 (3), 145-149. doi:10.5455/JMID.2026.v16.i3.2


Chicago Style

Ramaraj, Arokiamary, Karthika Jayakumar, Jaison Jayakaran, and Sandeep Kadali. "A rare case of Citrobacter youngae co-infection in a diabetic foot ulcer: Importance of deep tissue culture in a Tertiary Care Hospital." Journal of Microbiology and Infectious Diseases 16 (2026), 145-149. doi:10.5455/JMID.2026.v16.i3.2


MLA (The Modern Language Association) Style

Ramaraj, Arokiamary, Karthika Jayakumar, Jaison Jayakaran, and Sandeep Kadali. "A rare case of Citrobacter youngae co-infection in a diabetic foot ulcer: Importance of deep tissue culture in a Tertiary Care Hospital." Journal of Microbiology and Infectious Diseases 16.3 (2026), 145-149. Print. doi:10.5455/JMID.2026.v16.i3.2


APA (American Psychological Association) Style

Ramaraj, A., Jayakumar, . K., Jayakaran, . J. & Kadali, . S. (2026) A rare case of Citrobacter youngae co-infection in a diabetic foot ulcer: Importance of deep tissue culture in a Tertiary Care Hospital. Journal of Microbiology and Infectious Diseases, 16 (3), 145-149. doi:10.5455/JMID.2026.v16.i3.2


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