Chrysosporium, A New Causative Agent in Osteomyelitis

Abstract

A 24-year-old black man presented with a two-month history of swelling of the right ankle. Roentgenograms were initially read as negative. One month later the patient returned with increased pain and swelling, and roentgenograms demonstrated a large lucency involving the distal tibia. Bone scanning revealed extension of the lesion proximally, to 6 cm below the knee. Biopsy of a large tibial abscess demonstrated histocytic giant cells with budding yeasts and septate mycelia. Chrysosporium was isolated from cultures. Amphotericin B was used to treat the patient. Clinically, the infection healed within four months in a short-leg cast. Although Chrysosporium is usually a contaminant, its presence in cultures and histologic sections is evidence of pathogenicity.