Abstract
Blastomyces dermatitidis is an endemic mycosis in certain regions of the United States of America and can cause disseminated infection in immunocompetent individuals. We present a case of osseous blastomycosis in a previously healthy 22-year-old male from Missouri, who developed sudden onset right knee pain in June 2019. Magnetic Resonance Imaging (MRI) demonstrated an enhancing mass that was concerning for osseous malignancy. Antigen and antibody testing for dimorphic fungi was confounding. He underwent debridement and surgical specimen cultures grew B. dermatitidis. He was treated initially with liposomal amphotericin B and transitioned to oral itraconazole to complete therapy. Blastomycosis of the bone can be mistaken for malignancy and should be included on a differential for these types of cases. Blastomycosis of the bone and joints can be successfully treated with surgical debridement and prolonged antifungal therapy.
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