title: Osteomyelitis resulting from chronic filamentous fungus olecranon bursitis.
abstract: We describe a case of Phaeoacremonium olecranon osteomyelitis. The patient, initially felt to have traumatic olecranon bursitis, was found to have an indolent filamentous fungus cultured from the olecranon bursa. In retrospect, x-rays revealed bony erosion, which heightened the index of suspicion for infection in this particular case. Surgical bursal excision was performed and antifungal therapy was administered with clinical resolution. This case emphasizes that aspiration, synovial fluid analysis, and culture of bursal fluid is essential in excluding typical and atypical causes of chronic bursitis.
authors.affiliation: Department of Rheumatology, Geisinger Medical Center, Danville, Pennsylvania, 17822, USA. lcllinas@geisinger.edu
authors.forename: Laura
authors.initials: L
authors.lastname: Llinas
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Olenginski
authors.forename: David
authors.initials: D
authors.lastname: Bush
authors.forename: Robert
authors.initials: R
authors.lastname: Gotoff
authors.forename: Valerie
authors.initials: V
authors.lastname: Weber
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D002062:Bursitis / Q000382:microbiology* / Q000601:surgery; D002908:Chronic Disease; D004551:Elbow Joint / Q000382:microbiology* / Q000601:surgery; D005260:Female; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008875:Middle Aged; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy; D010019:Osteomyelitis / Q000382:microbiology* / Q000628:therapy
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole