Fatal disseminated infection caused by Prototheca zopfii in a child with leukemia

Sim, Jun Yi; Hsueh, Po-Ren; Chuang, Pei-Chien; Lee, Ping–Ing

doi:10.1016/j.jmii.2019.05.001

Cited by 8 publications

(8 citation statements)

References 6 publications

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“…We only reviewed cases with sufficient clinical information and laboratory/sequence data to identify the alga in the period 1970–2019. Of these, 35 articles presenting 37 cases of human disseminated/systemic protothecosis were included ( Table 1 ) ( 3 – 37 ).…”

Section: Methodsmentioning

confidence: 99%

“…There are various forms of skin lesions without specificity that can be manifested as erythematous papules, plaques, nodules, ulcers, papules, necrotic crusts, pustules, and bullae with purulent discharge, even presenting as an eczematoid eruption ( 4 , 15 , 19 , 25 , 31 ). At least three patients had lesions at the site of catheter implantation in this review ( 23 , 25 , 37 ). Unfortunately, even though skin lesions are the most common initial signs of this disseminated type, the mortality of patients with visual lesions was not lower than that of other factors, suggesting that atypical lesions were indeed overlooked or misdiagnosed by clinicians.…”

Section: Clinical Featuresmentioning

confidence: 99%

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Human Disseminated Protothecosis: The Skin is the “Window”?

et al. 2022

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Human disseminated protothecosis is a rare infection caused by members of the genus Prototheca, an achlorophyllic algae always associated with debilitated hosts. The presence of non-budding cells and large, spherical cells (sporangia) with endosporulation (morula) in histology is proof of Prototheca infection. Regrettably, due to the lack of specificity of clinical features and low awareness among clinicians, protothecosis is always underestimated and misdiagnosed. The available data on a species-specific analysis of this infection are limited. In this review, we summarize the etiological, epidemiological, and clinical aspects of disseminated protothecosis. The potential pathogenicity and clinical differences between P. zopfii and P. wickerhamii were observed. Additionally, the skin not only became the main invasion site but also the most involved organ by the pathogen. With the increasing numbers of immunocompromised individuals throughout the world, the incidence of disseminated infection caused by Prototheca is bound to increase, and disseminated protothecosis that accompanies skin symptoms should be taken into account by clinicians.

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Section: Methodsmentioning

confidence: 99%

Section: Clinical Featuresmentioning

confidence: 99%

Human Disseminated Protothecosis: The Skin is the “Window”?

et al. 2022

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“…There are 3 clinical types of protothecosis: cutaneous, the most common; olecranon bursitis; and systemic protothecosis, which can also affect the skin [ 13 , 14 ]. Unlike the previous series on patients infected with P. Wickerhamii , mortality from disseminated P. zopfii infection was much higher [ 12 ]. Milk and dairy products contaminated with P. zopfii primarily cause skin diseases, and can be a source of infection in humans and milking cows, then are disseminated in immune-compromised hosts [ 15 ].…”

Section: Discussionmentioning

confidence: 67%

“…Disseminated protothecosis is a fatal opportunistic infection that can arise in immunodeficient populations [ 12 ]. The pathogenesis of Prototheca is poorly understood; it mainly occurs in immunocompromised hosts and rarely in patients with intact immune systems.…”

Section: Discussionmentioning

confidence: 99%

Prototheca zopfii as a Cause of Pneumonia and Disseminated Infection in Febrile Neutropenia: A Case Report and Literature Review

et al. 2021

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Patient: Female, 48-year-old Final Diagnosis: Disseminated Prototheca zopfii • sepsis Symptoms: Diarhea • fatigue • fever • vomiting Medication: — Clinical Procedure: — Specialty: Infectious Diseases • Microbiology and Virology Objective: Rare disease Background: Prototheca spp. are common and found in various environments, including animal and human intestines, on the skin and in respiratory tissues, and colonizing fingernails. Few strains pathogenic for humans have been discovered. Here, we describe an infection by the pathogenic fungus species Prototheca zopfii in a patient. The infection was initially classified as a fungus based on colony morphology, fungal staining results, and growth in some fungi culture media (Sabouraud dextrose agar [SDA]). Reports of Prototheca spp. infections are increasing, often with poor outcomes. The use of matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS) technique for identification has been widely described. Phenotypic identification depends on microscopic examination of the direct wet mount and after subculturing in blood and SDA using different stains that show a typical morphological characteristic of Prototheca spp . Case Report: A 48-year-old woman was diagnosed with a P. zopfii infection after 22 days of hospitalization in the critical care unit. The patient had profound febrile neutropenia and absolute neutrophil count (ANC) was zero, associated with hypotension and disseminated intravascular coagulation (DIC) 10 days after receiving the first cycle of chemotherapy for metastatic breast adenocarcinoma. Unfortunately, the patient died within 2 days of the initiation of treatment with amphotericin B. Conclusions: This case report highlights algae infections as a possible opportunistic infection type in patients with profound neutropenia, and we discuss the use of MALDI-TOF MS-based technology in detecting such infections and predicting poor prognosis, especially in patients with the disseminated form with underlying febrile neutropenia.

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“…dziecko chore na białaczkę czy sześciomiesięczne dziecko z wrodzonym wodogłowiem, które zakażone zostało podczas zabiegów pielęgnacyjnych drenażu brzuszno-otrzewnowego [25,[27][28][29][30]. Przypadków prototekozy u ludzi na całym świecie jest niewiele w porównaniu z zakażeniami innymi patogenami, jednak zakażeń ciągle przybywa.…”

Section: Prototekozy U Ludziunclassified

Protothecosis in humans and animals

Krukowski¹,

Kułaga²

2022

Med Srod.

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Wprowadzenie i cel. Glony z rodzaju Prototheca to bardzo interesujące i wyjątkowe mikroorganizmy należące do królestwa roślin (Regnum Vegetabile), które są w stanie zakazić zwierzęta i ludzi, powodując choroby zwane prototekozami. Przez długi czas glony z rodzaju Prototheca nie były uznawane za patogeny groźne dla ludzi. Ewentualne izolacje tych mikroorganizmów z ran, krwi czy kału zazwyczaj interpretowano jako saprofity bądź też zanieczyszczenia. Celem pracy jest zaprezentowanie dotychczasowego stanu wiedzy dotyczącego biologii, identyfikacji oraz chorobotwórczości dla ludzi i zwierząt bezchlorofilowych glonów z rodzaju Prototheca. Opis stanu wiedzy. Prototekozy to dość nielicznie spotykane infekcje, wywoływane przez bezchorofilowe glony z rodzaju Prototheca, które są szeroko rozpowszechnione w środowisku. Glony te są patogenami dla zwierząt i człowieka. Prototheca spp. mogą powodować infekcje u ludzi, ale stanowią także problem w przypadku zakażeń zwierząt (przede wszystkim gdy wywołują zapalenie wymienia u krów mlecznych), przynosząc znaczące straty ekonomiczne. Budowa glonów z rodzaju Prototheca powoduje, że są one oporne na większość fungistatyków, antybiotyków, środków dezynfekcyjnych, a także cechują się opornością na wysokie temperatury. Podsumowanie. Ze względu na zdolność glonów Prototheca do zakażania organizmów zwierzęcych, jak i ludzkich oraz ich dużą oporność na wiele czynników i środków istotne jest pogłębienie wiedzy dotyczącej glonów Prototheca i lepsze poznanie tych niezwykle ciekawych mikroorganizmów, aby w przyszłości móc bardziej efektywnie leczyć prototekozy, które ze względu na zwiększającą się liczbę osób z obniżoną odpornością mogą dotyczyć coraz to więcej nie tylko zwierząt, ale także i ludzi.

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Fatal disseminated infection caused by Prototheca zopfii in a child with leukemia

Cited by 8 publications

References 6 publications

Human Disseminated Protothecosis: The Skin is the “Window”?

Human Disseminated Protothecosis: The Skin is the “Window”?

Prototheca zopfii as a Cause of Pneumonia and Disseminated Infection in Febrile Neutropenia: A Case Report and Literature Review

Protothecosis in humans and animals

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