Fungal osteomyelitis in children.

Fungal osteomyelitis is rare in children. Eumycetoma osteomyelitis occurs by direct external inoculation. Suspicion should be aroused when there are intermittent or persistent draining sinuses, even if bacterial cultures are positive. Treatment must be aggressive and should include radical local debridement. The quest for effective systemic chemotherapy should continue. Persistent drainage, ascending infection, and a functionless extremity are reasons for considering amputation.