Bilateral Choroiditis From Prototheca wickerhamii Algaemia

Unusual ulcerative keratitis caused by Prototheca wickerhamii in a diabetic patient

“…in 2005 reported first ocular infection of bilateral choroiditis by P. Wickerhamii algaemia in an immunocompromised patient with myelodysplastic syndrome. [ 1 ] In 2011, Solky et al . described a nonulcerative stromal keratitis that gradually leads to graft failure in a patient postpenetrating keratoplasty who had Fuchs endothelial dystrophy and uncontrolled steroid-induced glaucoma.…”

“…To confirm the identification of P. wickerhamii , we used primer set specific for P. wickerhamii targeting 18Sr RNA gene, forward primer 5′-TCA AAA AGT CCC GGC TAA TCT CGT GC-3′, reverse primer 5′-CGC TTT CGT GCC TCA ATG TCA GTG TT-3′, with the annealing temperature of 58°C, 35 cycles as described by Hariprasad et al . [ 1 ] However, the polymerase chain reaction (PCR) profile was optimized by us with the denaturation at 94°C annealing at 58°C, and extension at 72°C, for 35 cycles and the expected product was 319 base pairs (bp). The PCR performed yielded 319 bp specific product [ Fig.…”

Prototheca wickerhamii Infection of a Corneal Graft

“…The presence of thick-walled morule-like structures measuring 4-16 mm with multiple internal cleavages is helpful in making the diagnosis. 15 The culture shows creamy yeast-like colonies on Sabouraud medium when grown between 25 and 37°C.…”

“…8 Although many cases of disseminated protothecosis with ocular involvement have been reported in dogs, [10][11][12][13][14] ocular infection in humans is extremely rare. Hariprasad et al 15 reported the first human case of choroiditis because of algae in 2005 and an infection developing in an immunosuppressed patient with myelodysplastic syndrome who underwent bone marrow transplantation and chemotherapy. We report a nonulcerative stromal keratitis because of P. wickerhamii infection in a patient who underwent a PK.…”

Has the Polymerase Chain Reaction Come of Age for Ophthalmology?

“…Research uses of PCR have included discovery of the organisms underlying several uveitic syndromes, including Tropheryma whippelii underlying ocular Whipple disease and Bartonella henselae , responsible for some cases of stellate neuroretinitis. Most recently, PCR has been used to describe novel infections in the eye including algae 4 and novel herpes family viruses 5, 6; viral DNA triggering periocular tumors such as Kaposi sarcoma 7 and Merckel tumor 8 ; and ascribing viral causes to syndromes including Fuchs heterochromic cyclitis 9 and Posner-Schlossman syndrome 10 . Advances in the last decade have included the ability to test for multiple pathogens simultaneously (multiplex PCR) and the ability to perform quantitative PCR to determine pathogen load.…”