A Case Report of Distal Femur Fungal Osteomyelitis

Fungal osteomyelitis is an uncommon infection that can present with nonspecific symptoms, leading to delays in diagnosis. We report the case of a 27-year-old woman who presented with chronic right knee pain and intermittent swelling for three months. Imaging revealed a subcortical osteolytic lesion in the lateral condyle of the distal femur. The patient underwent surgical curettage and biopsy, which confirmed fungal osteomyelitis caused by Candida auris. Antifungal susceptibility testing showed resistance to multiple agents, with sensitivity to voriconazole. Following surgical debridement, the patient was treated with prolonged oral voriconazole for six months. At follow-up, she demonstrated complete clinical and radiological recovery with a good functional outcome. This case highlights the importance of considering fungal infection in persistent osteolytic lesions and emphasizes the role of biopsy, culture, and targeted antifungal therapy in achieving successful outcomes. C. auris osteomyelitis is exceedingly rare, with only a limited number of cases reported in the literature.