Background: Invasive fungal infection (IFI) is one of the most challenging complications in children with acute lymphoblastic leukemia (ALL) treatment, but acute fungal osteomyelitis (OM) is rarely encountered. Case presentation: Here, we describe a case of Candida tropicalis osteomyelitis in a 10-year-old patient with Philadelphia chromosome (Ph)–positive ALL. He was on remission induction therapy at the time of neutropenia, and abscess developed in the right arm. The blood and bone cultures

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... re positive for Candida tropicalis. Antibiotics and anti-fungal were given. A magnetic resonance of the arm revealed in intraosseous abscess, suggestive of OM. Surgical irrigation and debridement of the bone were performed immediately. The patient was effectively treated with antifungal therapy and ALL treatment. Now he full recovered into complete clinical remission but with sequelae visible by Magnetic Resonance Imaging (MRI). He took oral posaconazole for consolidation until disappearance of the lesion shadows on MRI and received subsequent cycles of chemotherapy in parallel. Conclusions: In the successful management of Ph-positive ALL, dasatinib the second-generation Abl–tyrosine kinase inhibitor is crucial. The recommended treatment for candida osteomyelitis in Ph-positive ALL patients are fungicidal agent combined with surgery and modification chemotherapy with dasatinib. Using combined modalities of treatment seem to be crucial in the successful management of Ph-positive ALL.