Cutaneous Protothecosis

Abstract

Prototheca species are an achlorophyllic algae that cause infections primarily in immunocompromised individuals. At least one-half of infectious cases are cutaneous. Because protothecosis is seldom suspected clinically, patients may be subjected to various treatment modalities for extended periods without satisfactory results. Cutaneous protothecosis shares similar clinical and pathologic findings with deep tissue fungal mycoses. The typical presentation occurs most commonly on the face and extremities as erythematous plaques, nodules, or superficial ulcers. Prototheca spp are spherical, unicellular, nonbudding organisms that are sometimes noted on routine hematoxylin-eosin staining but are best visualized with periodic acid–Schiff and Gomori methenamine-silver histochemical stains. Although protothecosis can be diagnosed on biopsy, culture of the organism on a medium such as Sabouraud dextrose agar is required for definitive diagnosis. Treatment may require a combination of surgical excision and antifungal agents. Therefore, cutaneous protothecosis should be considered in a lesion that appears suspicious for the more-common fungal infections.

Cutaneous protothecosis in an immunocompetent host

“…2,3 The typical presentation commonly occurs on the face and extremities as erythematous plaques, nodules or superficial ulcers. 4 We report a case of cutaneous protothecosis in an immunocompetent host.…”

“…The sporangia are characteristic of the Prototheca spp and tend to form morula-like structures that have internal septation with a cartwheel-like appearance. 4 The morula forms appear symmetrical in P. wickerhamii, whereas in other species of the Prototheca genus, the morula has a more random internal segmentation without the cartwheel-like appearance. 3,4 Symmetrical morula-like structures were also seen in our patient.…”

“…4 The morula forms appear symmetrical in P. wickerhamii, whereas in other species of the Prototheca genus, the morula has a more random internal segmentation without the cartwheel-like appearance. 3,4 Symmetrical morula-like structures were also seen in our patient. Prototheca spp.…”

Protothecosis in humans and animals

“…Ponieważ glony z rodzaju Prototheca są saprofitami i potrzebują ciągłego dostępu do rozkładającego się bądź też lekko strawionego pożywienia, częściej możemy znaleźć je w obornikach, ściekach czy odchodach. Saprofity te dodatkowo możemy spotkać w wielu produktach spożywczych, takich jak: mięso wieprzowe, mięso wołowe, krowie mleko czy owoce morza [1][2][3][4][5].…”

Protothecosis: the alterations in the human foot microbiome – a case study

“…The infection also affects skin and manifests itself by erosion, crusting, erythema, papules, plaques, clefts superficial ulcers and pustules. 4,5 The characteristic topography of the feet and large contact surface with the external area makes them a habitat for various strains of bacteria, fungi, algae, viruses and mites. Healthy skin of the foot is inhabited by the following bacteria: Corynebacteriaceae, Micrococcaceae, Lactobacillaceae, Streptococcaceae, Enterobacteriaceae, Proteobacteria and fungi: Malassezia, Aspergillus, Saccharomyces, Candida.…”