Hand (New York, N.Y.)
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Hand (New York, N.Y.) · Sep 2015
Coccidioidomycosis causing osteomyelitis of the hand in an immunocompetent patient.
Coccidioidomycosis osteomyelitis is a rare entity considered even more rare when identified in the immunocompetent patient. In non-endemic areas, the diagnosis of a fungus-causing osteomyelitis is often delayed or overlooked. This results in delayed or inappropriate treatment. ⋯ When he failed to improve, he presented for a second opinion. The patient's origin and travel history coupled with the appearance of rapid bone destruction on plain radiographs prompted a second operation for tissue biopsy and culture for bacteria, fungus, and mycobacteria cultures. This case highlights the importance of a thorough clinical history in deriving an appropriate differential diagnosis prior to surgical intervention.