Case Report: Alternaria Osteomyelitis: Eight Years of Recurring Disease Requiring Cyclic Courses of Amphotericin B for Cure

A 51-year-old man with a chronic maxillary sinus infection and osteomyelitis of adjacent bony structures had Alternaria identified as the cause of the infection by both pathologic examination and by culture. Although the fungus was shown to be susceptible to amphotericin B in vitro, clinical relapses occurred three times over an 8-year period, despite extensive surgical debridement and treatment with amphotericin B. Ultimately, cyclic courses of amphotericin B administered 2 years beyond clinical resolution of the disease were required to eradicate the fungal infection.