PMC6450135_01
Plain radiograph of a 9-year-old boy with a painful left thigh swelling of 5-month duration. There is a reduction in the corticomedullary differentiation of the distal diametaphysis of the femur with soft-tissue swelling, preserved fat plane, spiculated periosteal reaction, and cortical erosion
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F1
X-ray report showed a reduction in the corticomedullary differentiation of the distal metaphysis of the femur with soft-tissue swelling, preserved fat plane, spiculated periosteal reaction, cortical erosion, and cauterization [Figure 1].
Computed tomography scan report showed a reduced corticomedullary differentiation in the distal diametaphysis of the femur with a sunray periosteal reaction with cortical erosion and a hypodense avascular soft-tissue mass in the distal femur
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F2
Computed tomography (CT) scan report showed a reduced corticomedullary differentiation in the distal metaphysis of the femur with a sunray periosteal reaction with cortical erosion and a hypodense avascular soft-tissue mass in the distal femur [Figure 2].
This photomicrograph shows numerous multinucleated giant cells containing cytoplasmic round-to-oval fungal bodies. Furthermore, it observes numerous histiocytes with eccentrically located nuclei with cytoplasmic vacuoles containing oval-shaped fungal bodies of Histoplasma duboisii. Similar bodies were also seen in the giant cells and also extracellularly (H and E, x300)
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F3
Similar bodies were also seen in the giant cells and also extracellularly [Figure 3].
The fungal bodies are highlighted in this periodic acid-Schiff-stained section (x600)
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F4
The fungal bodies were also identified using periodic acid-Schiff-staining technique [Figure 4].
Six months after treatment with antifungal drugs
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F5
Follow-up in our hospital continued for the next 2 years and included clinical examination of the patient and x-rays of the affected femoral bone [Figure 5].