Disseminated protothecosis manifesting with multiple, rapidly-progressing skin ulcers: successful treatment with amphotericin B

Murata, Maho; Ito, Takamichi; Nagae, Konosuke; Nakano-Nakamura, Misa; Nishida, Ruriko; Takei, Kunio; Takahara, Masakazu; Uchi, Hiroshi; Nishimura, Kazuko; Masuda, Michiaki; Furue, Masutaka

doi:10.1684/ejd.2015.2518

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Most of our cases were initially treated with oral itraconazole, which was convenient and well tolerated. Intravenous amphotericin B was effective with the lowest initial MIC of 0.5 mg/mL dose but was often associated with intolerable side‐effects and, thus, should be reserved for severely ill patients or disseminated cases …”

Section: Discussionmentioning

confidence: 99%

Clinicopathological features and course of cutaneous protothecosis

Tseng

Chen

et al. 2018

Acad Dermatol Venereol

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Despite its rarity, cutaneous protothecosis has become more significant due to an increased prevalence of immunocompromised individuals. Steroid overuse or iatrogenic adrenal insufficiency predisposes individuals to high-risk infections. Neglecting the disease leads to a chronic and incurable state. Protothecosis should be suspected in chronic eczematous and ulcerative plaques on the limbs refractory to conventional antibacterial and antiviral treatments, especially in patients with adrenal insufficiency. Clinical suspicion should be confirmed by skin biopsies, and confirmed cases can be successfully treated with itraconazole.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological features and course of cutaneous protothecosis

Tseng

Chen

et al. 2018

Acad Dermatol Venereol

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“…Therefore, P. wickerhamii can be classified by the phylogenetic analysis of the ITS sequence into genotypes 1 and 2 represented by IFM 56379 and FL11‐0001, respectively . A recent case of disseminated protothecosis in Japan was also found to be caused by P. wickerhamii genotype 2 . It is possible that P. wickerhamii genotype 2 is more prevailing than genotype 1 in Japan.…”

Section: Discussionmentioning

confidence: 99%

“…3 A recent case of disseminated protothecosis in Japan was also found to be caused by P. wickerhamii genotype 2. 10 It is possible that P. wickerhamii genotype 2 is more prevailing than genotype 1 in Japan.…”

Section: Discussionmentioning

confidence: 99%

Case report of cutaneous protothecosis caused by Prototheca wickerhamii designated as genotype 2 and current status of human protothecosis in Japan

Inoue

Miyashita

Noguchi

et al. 2017

The Journal of Dermatology

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An 85-year-old Japanese woman presented with infiltrative erythema and ulceration on the extensor surface of her right forearm. Direct microscopic examination demonstrated spherical and morula-like sporangia, while histopathology revealed numerous microorganisms with a mulberry-like appearance in the dermis. Staining of the microorganisms also showed mulberry-like sporangia that resembled the spokes of a wheel. The isolated yeastlike microorganism had been identified as Prototheca wickerhamii genotype 2 in another independent study on the basis of its morphological, biochemical and genetic analysis. This case of protothecosis was recorded in Kyushu, Japan, and oral treatment with itraconazole 200 mg/day for 2 months was effective. Herein, we also summarize and analyze 39 cases of human protothecosis reported in Japan since the first record in 1983.

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“…In the immunosuppressed, cutaneous lesions may disseminate and this form of protothecosis has high mortality [2] . Such prognoses underscore the need for prompt diagnosis and rapid treatment of even apparently isolated skin disease, particularly in the context of immunosuppression [17] , [21] .…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of cutaneous protothecosis with liposomal amphotericin and oral itraconazole

McMullan

Pollett

Biswas

et al. 2016

Medical Mycology Case Reports

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Protothecosis is a rare algal infection, affecting primarily immunocompromised hosts. Optimal management is unclear: in-vitro antimicrobial breakpoints are not established and therapeutic decisions are primarily based on case reports. We present a case of cutaneous Prototheca wickerhamii infection in an immunosuppressed 63 year old male, successfully treated with liposomal amphotericin and prolonged itraconazole. Inoculation may have been through frequent hot-tub use, highlighting hot-tub exposure as an infection risk for the immunocompromised host.

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Disseminated protothecosis manifesting with multiple, rapidly-progressing skin ulcers: successful treatment with amphotericin B

Cited by 4 publications

References 7 publications

Clinicopathological features and course of cutaneous protothecosis

Clinicopathological features and course of cutaneous protothecosis

Case report of cutaneous protothecosis caused by Prototheca wickerhamii designated as genotype 2 and current status of human protothecosis in Japan

Successful treatment of cutaneous protothecosis with liposomal amphotericin and oral itraconazole

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