Allescheria boydii Osteomyelitis Following Multiple Steroid Injections and Surgery

This is a report of a 46-year-old male who developed an Allescheria boydii infection secondary to excision of an interdigital neuroma. Previously reported cases of infection occurred in an immunosuppressed patient and in patients on systemic corticosteroid therapy, but not associated with a surgical wound. This patient received multiple local corticosteroid injections which may have produced local as well as systemic immunosuppression. Fungal cultures were not taken for many months and thus the true etiology of the infection was not discovered until late. The importance of obtaining fungal cultures particularly in patients receiving corticosteroid therapy, either local infiltration or systemic, cannot be overemphasized.