Fungus or parasite or both: a diagnostic challenge.
Protothecosis is a rare opportunistic infection caused by achlorophilic algae Prototheca wickerhamii, mainly in immunocompromised hosts. Due to their morphologic appearance in routine culture media, they can often mimic yeast-like opportunistic pathogens such as Pneumocystis jirovecii. This can delay the identification of other culprit organisms. We present a fatal case of protothecosis in a 74-year-old immunosuppressed male with concomitant Pneumocystis jirovecii pneumonia (PJP). The presence of a coinfection along with resemblance in routine culture media and microbiological and histopathological staining can prove to be a diagnostic challenge and delay appropriate care of an immunosuppressed patient.
Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland, Ohio, USA.
Tanmay S
TS
Panchabhai
Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland, Ohio, USA.
Debabrata
D
Bandyopadhyay
Department of Dermatology, Dermatology and Plastic Surgery Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Melissa
M
Piliang
Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland, Ohio, USA.
Abhijit
A
Duggal
Immunocompromised host; Pneumocystis jirovecii; Prototheca wickerhamii