Mucormycotic osteomyelitis following anterior cruciate ligament reconstruction: A case report and literature review

We report a case of femoral osteomyelitis caused by Mucorales in a young, healthy male patient following ACL reconstruction. Fungal osteomyelitis of the extremities is a rare condition primarily caused by Aspergillus or Candida in immunocompromised patients. Diagnosis is often delayed until standard antibiotic regimens fail. Current guidelines recommend systemic amphotericin B with surgical debridement; however, the drug’s clinical use is restricted by severe nephrotoxicity. To mitigate systemic toxicity, amphotericin B–loaded Polymethyl Methacrylate (PMMA) spacers have been investigated, though drug release remains short-lived. Early diagnosis—suggested by cortical and medullary bone destruction on imaging—along with timely amphotericin B therapy and surgical debridement, remains the cornerstone of effective management.