School of Podiatric Medicine Publications and Presentations
Document Type
Article
Publication Date
11-20-2025
Abstract
Providencia rettgeri is a Gram-negative bacterium, rarely reported as a cause of diabetic wound infections. Its frequent resistance to β-lactams and carbapenems limits treatment options, especially in immunocompromised patients. We present the case of a 59-year-old unhoused male living with diabetes, peripheral artery disease, and prior bilateral transmetatarsal amputations who presented with a University of Texas 3B diabetic foot ulcer. Magnetic resonance imaging showed osteomyelitis of metatarsals 2–4, and bone biopsy grew Providencia rettgeri and Proteus mirabilis. The patient declined further surgery and was treated with 6 weeks of cefepime and metronidazole, with outpatient wound care, achieving wound closure in 3 months. We performed a systematic scoping literature review on Providencia rettgeri wound infections in humans, detailed below, which identified only eight studies that met our inclusion and exclusion criteria. Most cases involved snake bites or critically ill patients, and none documented lower extremity bone involvement. Resistance patterns varied, but co-infection was common. Given its rarity and potential for multidrug resistance, Providencia rettgeri should remain on the differential for non-healing diabetic wounds. This case expands the limited literature and highlights the importance of culture-driven antibiotic therapy in complex infections. Recognition of Providencia rettgeri as a rare but clinically significant pathogen in diabetic foot osteomyelitis has implications for empiric antibiotic selection and clinical outcomes.
Recommended Citation
Campbell, S. N., Mehaffey, M., Gambhir, N., & Killeen, A. L. (2025). Providencia rettgeri as an unusual pathogen in diabetic foot osteomyelitis: A case report and literature review. Sage Open Medical Case Reports, 13, 2050313X251395970. https://doi.org/10.1177/2050313X251395970
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Publication Title
SAGE open medical case reports
DOI
10.1177/2050313X251395970
Comments
This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).