Humeral Osteomyelitis with Apophysomyces ossiformis in an Immunocompetent Patient: A Case Report

Introduction: Osteomyelitis of a limb can lead to devastating functional consequences. Fungal osteomyelitis is rare in immunocompetent patients, and compared to bacterial osteomyelitis, fungal infections are more difficult to eradicate. Case Report: We present a case of a 59-year-old male who suffered traumatic left open radius and ulna fractures at the elbow with significant soft tissue loss. He underwent spanning fixation across the elbow, and soft tissue coverage was provided with a free latissimus flap. At the time of flap coverage, the patient was found to have fungal osteomyelitis with the organism Apophysomyces ossiformis. The patient achieved wound closure and functional use of the left upper extremity. Conclusion: The reported case demonstrates the pathogenicity of a microorganism not previously described in human disease. In this case, treatment was successful with local debridement, placement of antibiotic beads, and long-term antifungal therapy.