Case for diagnosis. Ulcer and papular lesions in a patient with diabetes mellitus. Protothecosis

Abstract

Protothecosis is a rare disease caused by achlorophilic algae of the genus Prototheca spp . In general, three clinical forms are observed: cutaneous, articular and systemic. The cutaneous form is the most common one. This study describes a patient with isolated erythematous papules and erythematous papular plaques in the scapular regions, with a previous histopathological diagnosis of cryptococcosis. New tests were conclusive for the diagnosis of protothecosis, caused by Prototheca wickerhamii .

Cutaneous protothecosis in a solid organ transplanted patient

“…Within the species of the Prototheca genus, Prototheca wickerhamii and zopfii are the ones that most frequently affect immunocompromised hosts. 1 , 2 …”

“…The definitive diagnosis of infection is usually based on the morphological identification of the organisms in culture preparations in wet slides and/or direct identification in tissue samples as in the reported case. 1 , 2 , 3 , 4 …”

“…On the other hand, when it presents in a disseminated form, it has a worse prognosis, with high mortality. 1 , 5 The most commonly used medications are antifungals, including amphotericin B and systemic azoles. Amphotericin B is currently the first-line treatment in disseminated cases and in patients with severe underlying diseases or immunosuppression.…”