Multifocal osteomyelitis caused by Paecilomyces varioti in a patient with chronic granulomatous disease

This report describes an 18-year-old male patient with chronic granulomatous disease who developed cutaneous nodules and multifocal osteomyelitis with the saprophytic fungus Paecilomyces varioti. After several biopsies the organism was identified. Anti-fungal susceptibility testing was performed. Combination therapy with amphotericin B and gamma-interferon followed by long-term therapy with itraconazole and gamma-interferon resulted in a clinical response.