Successful treatment of fungal osteomyelitis with voriconazole in a patient with chronic granulomatous disease

Chronic granulomatous disease [CGD] is an immunodeficiency affecting phagocytic leukocytes. Defective respiratory burst mechanism renders the affected patients to be susceptible to catalase positive microorganisms. With the great successes in antibacterial prophylaxis and therapy, fungal infections are a persistent problem. Invasive aspergillosis is the most important cause of mortality in CGD. We describe a nine-year-old boy with CGD who presented with aspergillus induced skull osteomyelitis. He was successfully treated with voriconazole after initial failure of amphotericin B therapy. Currently, newer triazoles are recommended as initial therapy for invasive aspergillosis in immunodeficiency states such as CGD