Cutaneous protothecosis - case report

Abstract

Cutaneous protothecosis is a rare infection caused by achlorophyllic algae of the genus Prototheca. The lesions usually occur on exposed areas, related with trauma, in immunocompromised patients. The most common clinical presentation is a vesicobullous and ulcerative lesion with pustules and scabs, simulating bacterial, fungal or herpetic infections or eczema. The diagnosis is determined by agent identification through histopathology, culture and the carbohydrates assimilation test. The finding of morula-like spherules is characteristic of Prototheca sp. Its rarity and non-specific clinical aspect may difficult the disease diagnosis. We report a case of a diabetic patient, in chronic use of systemic corticosteroids, that developed a skin lesion after trauma to the right leg.

Protothecal bursitis after simultaneous kidney/liver transplantation: a case report and review

“…In Latin America, 8 cases of cutaneous protothecosis have been reported. In Brazil, 4 cases of protothecosis caused by P. wickerhamii have been reported in immunocompetent patients and patients exposed to steroids . In Colombia, 4 cases of Prototheca species infection before our current case have been reported: 3 cases of cutaneous infection, 1 case of periungueal infection, and 1 case of olecranon bursitis .…”

Cutaneous Protothecosis in a Patient with Chronic Lymphocytic Leukemia: A Case Report and Literature Review

“…Most protothecosis infections occur in patients with predisposing factors, such as human immunodeficiency/acquired immunodeficiency syndrome, diabetes mellitus, underlying malignancy, chemotherapy, radiotherapy, renal transplantation and prolonged systemic corticosteroid administration [ 20 , 21 , 22 ]. Of approximately ninety-four total reports of cutaneous protothecosis, the most common risk factors appear to be diabetes mellitus (21%) and chronic steroid use (24%) [ 6 , 9 , 23 , 24 , 25 , 26 , 27 ]. Malignancy is associated in only 9% of cases; however, the presence of multiple other risk factors in conjunction with neoplasia warrants the consideration of protothecosis in the differential diagnosis when puzzling non-specific skin lesions are detected.…”

Protothecosis algaemia in a patient presenting with septic arthritis: A rare case of Prototheca zopfii isolated from Malaysia

“…They are widely distributed in the environment [ 1 , 2 ] and may colonize skin, hair and nails [ 1 ]. Clinically, Prototheca sp are reported to be associated with cutaneous lesions, olecranon bursitis and systemic disorders in humans [ 1 , [3] , [4] , [5] , [6] ]. Risk factors for protothecosis include a background of immunological compromise and trauma [ 1 , 5 , 6 ].…”