FIG 3.

Fusarium osteomyelitis of the head of the 4th and 5th metacarpal bones with soft tissue involvement and septic arthritis of the 4th and 5th metacarpophalangeal (MCP) joints. A 68-year-old leukemic male presented with left-shin ulceration and multiple subcutaneous nodules while on posaconazole prophylaxis after two cycles of chemotherapy for acute myelogenous leukemia. Skin biopsy specimen and blood cultures grew Fusarium spp. He then developed pain/swelling/tenderness of the left 5th MCP joint and left metacarpal. MRI showed bony destruction of the head of the 5th metacarpal and soft tissue involvement with extension into the left 5th MCP. Intraoperative findings were consistent with osteomyelitis and septic arthritis.