Protothecosis in patients with cancer: case series and literature review

Abstract

Protothecosis is an uncommon infection in cancer patients, implying that Prototheca spp. have a low pathogenic potential in this population. Pulmonary involvement in particular is uncommon in these patients. Amphotericin B appears to be the most effective antifungal agent; the role of triazoles in treating protothecosis is uncertain, but they may be less effective.

Unusual Fungal and Pseudofungal Infections of Humans

“…Prototheca infection is generally introduced via traumatic inoculation and has been reported on all continents except Antarctica (63). In the United States, protothecosis is reported most often in the Southeast (93,105).…”

“…Three forms of human protothecosis are described: (i) cutaneous, (ii) olecranon bursitis, and (iii) disseminated (47,49,93). At least half of protothecosis cases are simple cutaneous infections (47,49).…”

“…At least half of protothecosis cases are simple cutaneous infections (47,49). The majority of these infections occur in individuals who are compromised by immunosuppressive therapy, AIDS, malnutrition, renal or hepatic disease, cancer, or autoimmune disorders (11,49,93,104,105). Lesions usually arise in areas exposed to traumatic implantation and present in an indolent fashion as nodules, papules, or an eczematoid eruption.…”

“…Signs and symptoms appear gradually several weeks following the trauma and include mild induration of the bursa accompanied by tenderness, erythema, and production of a variable amount of serosanguinous fluid. Disseminated protothecosis is rare and almost always occurs in individuals with severe immunocompromise from cancer treatment, a prior solid organ transplant, or AIDS (36,43,48,54,93,104). The organs most commonly affected in disseminated infection are skin, subcutaneous tissue, and spleen (93).…”

“…Disseminated protothecosis is rare and almost always occurs in individuals with severe immunocompromise from cancer treatment, a prior solid organ transplant, or AIDS (36,43,48,54,93,104). The organs most commonly affected in disseminated infection are skin, subcutaneous tissue, and spleen (93). Central venous catheter-related algaemia has been reported with accompanying fever, chills, and sepsis syndrome (48,93).…”