Fungal infection of bone is very rare. A 39 year old man, laborer by profession presented to out patient department with complaints of multiple discharging sinus in dorsum and palmar aspect of hand.
The problem had been there for about 4 months and severity had increased in spite of treatment with antibacterial and antitubercular drugs.
An xray was taken which revealed osteomyelitis of metacarpals and carpals.
In the xray all metacarpals except thumb metacarpals were involved and so were distal row of carpal bones. Note that metacarpals are sclerotic and deformed. Compare them with normal metacarpal of the thumb. Carpal bones can be compared to proximal row of carpal bones which are normal.
A culture for fungi cam positive and patient was put on antifungal drugs.
Unfortunately, he neve returned back for follow up.
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