Protothecosis.
Protothecosis is a rare infection caused by achlorophyllic algae that are members of the genus Prototheca. They are ubiquitous in nature in organic material. The clinical manifestations can be acute or chronic and local or disseminated. The disease is classified as cutaneous, causing bursitis or disseminated/systemic, affecting both immunocompetent and immunosuppressed patients, with more severe and disseminated infections occurring in immunocompromised individuals. Prototheca wickerhamii and Prototheca zopfii are the most frequent organisms reported in humans. Diagnosis is made by observing asexual sporangia (thecas) on histopathological examination of tissue. Medical and surgical treatment should be considered. Ketoconazole, itraconazole, fluconazole, voriconazole, posaconazole, and amphotericin B are the most commonly used antifungals. Voriconazole and amphotericin B are highly effective against Prototheca spp. Treatment failure is not uncommon because of the comorbidities that limit the therapeutic outcome.
Instituto Dermatológico de Jalisco Dr. José Barba Rubio, Zapopan, Avenida Federalismo #3102, Colonia Atemajac, Zapopan, Jalisco, Mexico. jormayo64@yahoo.com.mx
Jorge
J
Mayorga
José Fernando
JF
Barba-Gómez
Ana Paula
AP
Verduzco-Martínez
Víctor Fernando
VF
Muñoz-Estrada
Oliverio
O
Welsh
D000935:Antifungal Agents / Q000627:therapeutic use*; D002062:Bursitis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D006801:Humans; D009894:Opportunistic Infections / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D011525:Prototheca / Q000302:isolation & purification*; D012874:Skin Diseases, Infectious / Q000150:complications / Q000188:drug therapy* / Q000473:pathology
D000935:Antifungal Agents