Osteoarthritis caused by Neocosmospora vasinfecta

We report the case of a patient who developed an ankle osteoarthritis due to the Ascomycete Neocosmospora vasinfecta, following accidental multiple trauma to his legs in whilst in Africa. Antifungal susceptibility testing was performed. Despite a low amphotericin B minimal inhibitory concentration, parenteral antifungal therapy failed and amputation was required to resolve the osteoarthritis. Possible reasons for the failure of this antifungal treatment are examined.