Background: Infection of local bone with Histoplasma capsulatum is rare and difficult to diagnosis, and occurs particularly in immunocompetent subjects, who are more likely to be affected by a wide range of organisms.
Case presentation: An 11-year-old boy presented with localized histoplasmosis osteomyelitis in the left fibula without any evidence of abnormal immunological function or systemic disease. After surgical clearance of the lesion and homologous cancellous bone, the patient was treated orally with voriconazole for 6 months. The patient completely recovered with full function of his left leg during the 5-year follow-up.
Conclusions: Histoplasmosis osteomyelitis can occasionally occur in immunocompetent individuals and can be complete cured by surgical clearance of the lesion and antibiotic treatment.