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We describe a case of left hand extensor tenosynovitis due to histoplasmosis in a patient with dermatomyositis on chronic immunosuppression. Treatment involved surgical debridement and antifungal therapy. The patient experienced paradoxical worsening of tenosynovial inflammation during de-augmentation of immunosuppression felt to be immune reconstitution inflammatory syndrome.

journal of bone and joint infection

Left hand extensor tenosynovitis due to &amp;lt;i&amp;gt;Histoplasma capsulatum&amp;lt;/i&amp;gt; complicated by immune reconstitution inflammatory syndrome