Prototheca wickerhamii Infection of a Corneal Graft

Abstract

Algae are generally noninfectious agents in mammals, with few known pathogenic algae. Prototheca is an achlorophylic nonphotosynthetic algae, globally ubiquitous, and readily isolated from rivers, lakes, ponds, and soil. Although canine and bovine protothecosis have been reported more widely, infections in humans are rare, particularly in patients with an intact immune system. The majority of protothecal infections in humans is associated with Prototheca wickerhamii. We report an unusual case of P. wickerhamii infection in an immunocompetent corneal transplant patient.

<p>Long Term Follow-Up of <em>Prototheca</em> keratitis: A Case Report</p>

“…In the first case, a Prototheca infection was detected in a patient after undergone PKP for Fuchs corneal endothelial dystrophy. 2 In the second case, Prototheca keratitis and chronic endophthalmitis were found in a patient with Steven-Johnson syndrome and Boston type1 keratoprosthesis. 3 The third patient had ulcerative Prototheca keratitis and was a diabetic patient post corneal trauma with no prior ocular surgery.…”

“…They were treated with triazole and polyene, anti-fungal drugs, and surgical excision. [2][3][4] The treatment of two of three cases was successful, but of one case of an immunocompromised patient failed.…”

Unusual ulcerative keratitis caused by Prototheca wickerhamii in a diabetic patient

“…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. [ 12 ] Recently, in 2016, protothecal infection of an eye with Boston type 1 keratoprosthesis in a patient with Stevens-Johnson Syndrome and chronic ocular surface disease and multiple systemic complications was reported by Ng et al . [ 13 ] Although low virulence was noted, treatment was difficult with persistence, recurrence, or even widespread dissemination as in immunocompromised individuals.…”

Prototheca wickerhamii breast implant infection after reconstructive surgery: a new level of complexity

“…Device and prosthesis-associated Prototheca infections have included peritonitis with Tenckhoff catheters, meningitis after insertion of ventriculoperitoneal (VP) shunts, nasopharyngeal ulceration with endotracheal intubation, vascular access device-related algaemia and keratitis or endophthalmitis associated with corneal grafts (Refer to Table 1 ) [ [1] , [2] , [3] , [4] , [5] , [6] , [7] ]. Breast reconstruction devices including tissue expanders and implants are being used increasingly in the treatment of breast cancer [ 8 ].…”