Protothecosis Following Hand Injury A Case Report

Abstract

A case of protothecosis following an accidental cut on the dorsum of the hand by a fragment of glass from an exploding beer bottle is described. The area was widely excised and oral tetracycline given. No recurrence has been seen over a period of four years.

Human Protothecosis

“…Hospital-acquired cases of protothecosis have been reported in association with surgery and orthopedic procedures (53,54,94,100,139,150). Infection may also occur by penetration of the agent when a skin injury comes in contact with contaminated water (45,59,161).…”

“…Prototheca infection is exogenous or endogenous and usually nontransmissible (55,75,100,150); it is believed that Prototheca species may infect humans through contact with potential sources, such as contaminated soil or water, by traumatic inoculation with the algae, or even through insect bites (22,75,139,163). Also, rare cases of onychoprotothecosis have been described (47,168).…”

“…2) (64, 75). The lack of characteristic endospores causes Prototheca to resemble nonsporulating cells of Blastomyces dermatitidis, Cryptococcus neoformans, Paracoccidioides brasiliensis, and some stages of Coccidioides immitis, Pneumocystis jiroveci, Rhinosporidium seeberi, and the agent causing chromomycosis (8,38,88,114,139,140,149,162); thus, diagnosis of Prototheca species infection by histopathology can be difficult. The size of the sporangia is helpful in distinguishing Prototheca from other fungi.…”

Protothecal Tenosynovitis

“…Reports of Protothecal tenosynovitis are rare in the orthopaedic literature [17]. We report a case of protothecal tenosynovitis in a middle-aged immunocompetent woman after she underwent sclerosing therapy of varicose veins, and we review the published cases of protothecal tenosynovitis.…”

“…Approximately 117 patients with protothecal infections have been described in the literature [10] with a few involving synovial tendon sheaths [9,[12][13][14]17]. Reports of Protothecal tenosynovitis are rare in the orthopaedic literature [17].…”