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Tibial osteomyelitis due to Fonsecaea pedrosoi in an immunocompetent patient: case report

Raju Karuppal1, Chathoth Meethal Kumaran, Anwar Marthya

  • 1Department of Orthopaedics, Medical College, Calicut, Kerala, India. drrajuortho@rediffmail.com

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|August 25, 2009
PubMed
Abstract

Insights

Dematiaceous fungi like Fonsecaea pedrosoi can cause phaeohyphomycosis. This case highlights F. pedrosoi osteomyelitis in an immunocompetent patient, emphasizing diagnostic challenges and treatment complexities.

Area of Science:

  • Medical Mycology
  • Infectious Diseases

Background:

  • Dematiaceous fungi cause phaeohyphomycosis, with diverse clinical presentations.
  • Fonsecaea pedrosoi infections are increasing, especially in immunocompromised individuals.
  • F. pedrosoi can colonize normal skin.

Observation:

  • A case of F. pedrosoi osteomyelitis in an immunocompetent patient is presented.
  • This presentation is unusual as F. pedrosoi typically affects immunocompromised hosts.

Findings:

  • Definitive diagnosis requires tissue culture and pathological examination.
  • Distinguishing between infection and colonization is crucial for appropriate management.
  • Osteomyelitis caused by F. pedrosoi can occur in immunocompetent individuals.

Implications:

  • A high index of suspicion and routine fungal cultures are necessary for early identification.
  • Treatment involves antifungal drugs (e.g., itraconazole) and aggressive surgical debridement.
  • Optimal outcomes may be challenging due to the angioinvasive nature of F. pedrosoi.

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