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Further investigation with surgical debridement, plain X-ray, MRI and wound culture revealed concomitant <jats:italic>Citrobacter koseri<\/jats:italic> septic arthritis with osteomyelitis. <jats:italic>C. koseri<\/jats:italic> is considered an opportunistic infection that rarely causes musculoskeletal infections. Acute gouty arthritis and septic arthritis are rarely seen occurring concomitantly in the same joint and are often difficult to differentiate due to similar findings on exam and imaging. The present case illustrates that osteomyelitis with an opportunistic organism can present concomitantly with acute gouty arthritis, and the diagnosis of one should not exclude the other.<\/jats:p>","DOI":"10.1136\/bcr-2019-230432","type":"journal-article","created":{"date-parts":[[2019,7,27]],"date-time":"2019-07-27T11:46:11Z","timestamp":1564227971000},"page":"e230432","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["<i>Citrobacter koseri<\/i> causing osteomyelitis in a diabetic foot with concomitant acute gouty arthritis successfully treated with ertapenem"],"prefix":"10.1136","volume":"12","author":[{"given":"Dillon","family":"Tinevez","sequence":"first","affiliation":[{"name":"Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8028-1495","authenticated-orcid":false,"given":"Nebojsa Nick","family":"Knezevic","sequence":"additional","affiliation":[{"name":"Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA"},{"name":"Anesthesiology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,7,27]]},"reference":[{"key":"2025082623144381000_12.7.e230432.1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.50.4962"},{"key":"2025082623144381000_12.7.e230432.2","doi-asserted-by":"publisher","DOI":"10.1086\/515106"},{"key":"2025082623144381000_12.7.e230432.3","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1308\/rcsann.2016.0209","article-title":"Musculoskeletal infections associated with Citrobacter koseri","volume":"98","author":"Kwaees","year":"2016","journal-title":"Ann R Coll Surg Engl"},{"key":"2025082623144381000_12.7.e230432.4","doi-asserted-by":"crossref","first-page":"193","DOI":"10.26510\/2394-0859.pbe.2017.31","article-title":"Assessment of bacterial contamination of toilets and bathroom doors handle\/knobs at Daeyang Luke hospital","volume":"4","author":"Ngonda","year":"2017","journal-title":"Pharmaceutical and Biological Evaluations"},{"key":"2025082623144381000_12.7.e230432.5","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/2.5.746"},{"key":"2025082623144381000_12.7.e230432.6","first-page":"146","article-title":"Osteomyelitis Due to Citrobacter koseri Infection in a Diabetic Patient","volume":"1","author":"Arslan","year":"2011","journal-title":"J Endocrinol Metab"},{"key":"2025082623144381000_12.7.e230432.7","unstructured":"Oliver TI , Mutluoglu M . 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