Infections of bone or joints that present histologically as granulomas may be grouped together, include both bacterial and fungal etiologies. These infections are uncommonly encountered. Hence, there is rarely a standardized approach to the establishment of the diagnosis or the choice of therapy. From a practical standpoint, it is useful to maintain this classification, which is based on the histologic appearance, because if the frozen section shows a granuloma at the time of open biopsy, appropriate studies may be initiated.