Chronic granulomatous disease - Paecilomyces is a catalase positive fungi with low pathogenicity. However, it can cause invasive visceral, lung, bone, and skin infections in patients with CGD. This organism ranked as the third most common cause of osteomyelitis in the United States CGD registry. Most reported infections were caused by Paecilomyces variotti. Certain Paecilomyces species are highly resistant to Amphotericin B (P. lilacinus, P. marquandii). Newer triazoles such as voriconazole and posaconazole demonstrate good in vitro activity against P. lilacinus. Thus, species and sensitivities should always be determined in order to initiate appropriate therapy.