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Ann Clin Microbiol Antimicrob 2022 Feb 14;21(1). Epub 2022 Feb 14.

Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Background: Protothecosis is a rare infection in humans and animals caused by the achlorophyllic algae Prototheca species. More than half of the protothecosis cases are cutaneous infections, and most cases are observed in immunocompromised individuals.

Case Presentation: We report a case of Prototheca wickerhamii infection in the mucosa of the pharynx in a 53-year-old immunocompetent woman with an incidentally found mass lesion at the left tongue base. Read More

Clin Dermatol 2021 Dec 31. Epub 2021 Dec 31.

Department of Dermatology and Allergy, Technische Universität München, Munich, Germany. Electronic address:

Annular configuration is conspicuous in the clinical manifestation of many skin diseases and can be helpful for the diagnosis and differential diagnosis. Variations may include arciform, ring-form, annular, circinate, serpiginous, gyrated, polycyclic, targeted or figurate forms, in different colors, sizes, and numbers, with various textures and surfaces. In infectious dermatoses, the annular reactions can be specific or nonspecific, while the underlying mechanisms remain largely unknown. Read More

Cutis 2021 Aug;108(2):E25-E27

Drs. Baigrie and Sandoval are from the Department of Dermatology, Sampson Regional Medical Center, Clinton, North Carolina, and Campbell University, Buies Creek, North Carolina. Drs. WJ White and WC White are from Coastal Carolina Pathology, Wilmington, North Carolina. Dr. Tanner is from the Department of Dermatology, Wilmington Health, North Carolina.

Infect Drug Resist 2021 20;14:2787-2794. Epub 2021 Jul 20.

Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People's Republic of China.

Human protothecosis is a rare infection caused by spp., which are environmental achloric algae ubiquitously existing in nature. Members of the genus of usually cause localized infection that affects the skin or wounds. Read More

An Bras Dermatol 2021 Sep-Oct;96(5):613-616. Epub 2021 Jul 13.

Fundação de Dermatologia Tropical e Venereologia Alfredo da Matta, Manaus, AM, Brazil.

Protothecosis is a rare disease caused by achlorophilic algae of the genus Prototheca spp. In general, three clinical forms are observed: cutaneous, articular and systemic. The cutaneous form is the most common one. Read More

IDCases 2021 12;24:e01121. Epub 2021 Apr 12.

Mycology Section, Bacteriology Unit, Infectious Disease Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia.

Prototheca species have been reported to cause infections in human. Typically, clinical symptoms of protothecosis include cutaneous infection, olecranon bursitis, tenosynovitis and disseminated systemic disease. We report a case of septic arthritis in which was isolated from blood. Read More

J Vet Diagn Invest 2021 Jan 3;33(1):156-161. Epub 2020 Dec 3.

Istituto Zooprofilattico Sperimentale delle Venezie, Legnaro, Padua, Italy.

Protothecosis is an uncommon disease caused by algae of the genus . In dogs, the infection is usually first localized to the colon but has the propensity to later disseminate hematogenously to many other organs, with marked tropism for the eyes and central nervous system. Diagnosis is established by culture and/or evidence of organisms in cytologic or histologic preparations. Read More

Skinmed 2020 1;18(5):312-314. Epub 2020 Oct 1.

Pathology Department, University Hospital Crosshouse, NHS Ayrshire & Arran, Scotland, UK;

A 67-year-old Scottish woman presented to her general practitioner with a subcentimeter lump between her shoulder blades. The lump was suspected to be an epidermal cyst and was excised. The patient had a history of controlled diabetes. Read More

J Clin Lab Anal 2020 Nov 21;34(11):e23492. Epub 2020 Jul 21.

Department of Clinical Laboratory, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Background: Prototheca species are a group of organisms ubiquitously existing in nature but have become a pathogenic threat to public health, which has aroused wide attention. Species identification and antifungal susceptibility have essential and valuable meanings to clinical diagnosis and treatment.

Methods: A case of an 84-year-old patient who had suffered from multiple cutaneous infections was reported. Read More

Indian J Dermatol Venereol Leprol 2020 Jul-Aug;86(4):414-417

Department of Dermatology, Goa Medical College, Bambolim, Goa, India.

Mycopathologia 2020 06 17;185(3):595-596. Epub 2020 May 17.

Department of Dermatology, The Affiliated Hospital, Guizhou Medical University, Beijing Road 4, Yunyan District, Guiyang, China.

Australas J Dermatol 2020 Aug 5;61(3):277-279. Epub 2020 Mar 5.

Private practice, Bankstown, NSW, Australia.

Front Cell Infect Microbiol 2020 7;10:31. Epub 2020 Feb 7.

Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada.

(formerly genotype-II) is an opportunistic, achlorophyllous alga that causes mastitis in cows and skin disease in cats and dogs, as well as cutaneous lesions in both immunocompetent and immunosuppressed humans. Antifungal medications are commonly ineffective. This study aimed to investigate innate immune responses contributed by cathelicidins to in the mammary gland using a mastitis model in mice deficient in the sole murine cathelicidin (). Read More

An Bras Dermatol 2020 Mar - Apr;95(2):210-213. Epub 2020 Jan 21.

Department of Dermatology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Protothecosis is a rare condition caused by the aclorophylated algae of the genus Prototheca. In humans, protothecosis, caused mainly by P. wickerhamii, manifests itself in three forms: cutaneous, articular and systemic. Read More

J Clin Aesthet Dermatol 2019 Dec 1;12(12):13-16. Epub 2019 Dec 1.

Drs. El Hoshy, Abdel-Halim, El-Nabarawy, and Shalaby are with the Dermatology Department at Cairo University in Cairo, Egypt.

A 77-year-old female patient presented with bilateral tender, swollen, erythematous, focally crusted cheeks with a discharge of pus and necrotic material, which had developed one month after autologous fat transfer and a corrective injection procedure conducted to correct an overdone fat transfer. Histopathological examination of the discharged material using routine hematoxylin and eosin staining revealed degenerated collagen admixed with three different filler materials. Scattered all throughout the specimen were numerous thick-walled, basophilic, nonbudding spherical bodies of variable sizes. Read More

Photodiagnosis Photodyn Ther 2019 Mar 23;25:280-284. Epub 2018 Dec 23.

Department of Dermatology, Affiliated Third Hospital of Hangzhou, Anhui Medical University, West Lake Rd 38, Hangzhou, China. Electronic address:

Background: Antimicrobial photodynamic therapy(aPDT) has been used to treat localized cutaneous fungal infections that have an enhanced antifungal susceptibility profile. The aim of this study was to evaluate the effect of ALA aPDT on both the growth and the antimicrobial and antifungal susceptibility of Prototheca wickerhamii.

Methods: Six isolates of P. Read More

Curr Trop Med Rep 2018 Dec 6;5(4):224-227. Epub 2018 Aug 6.

Hospital Infantil de México, Federico Gómez, Mexico City, Mexico.

Purpose Of Review: is a slow-growing member of the nontuberculous mycobacterial species that manifests clinically with pulmonary, cutaneous, or disseminated forms. Most cases of infection occur in immunocompromised hosts including HIV/AIDS, solid-organ transplantation, anti-interferon-γ antibody disorder, or among those with pulmonary disorders such as chronic obstructive pulmonary disease or cystic fibrosis. In this review, we aim to discuss relevant literature regarding the clinical manifestations of this infection with a particular emphasis on the clinical spectrum and treatment of the cutaneous manifestations of this mycobacterial infection. Read More

Mycopathologia 2018 Oct 16;183(5):821-828. Epub 2018 Aug 16.

Department of Dermatology, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhongshan Er Road, Guangzhou, 510080, China.

We present a case of cutaneous protothecosis caused by Prototheca wickerhamii infection. The patient was a 72-year-old man with hypoalbuminemia. He responded well to fluconazole treatment. Read More

J Clin Microbiol 2018 10 25;56(10). Epub 2018 Sep 25.

Department of Molecular Phylogenetics and Evolution, Biological and Chemical Research Centre, Faculty of Biology, University of Warsaw, Warsaw, Poland.

Achlorophyllous unicellular microalgae of the genus (, ) are the only known plants that cause infections in both humans and animals, collectively referred to as protothecosis. Human protothecosis, most commonly manifested as cutaneous, articular, and disseminated disease, is primarily caused by , followed by and, sporadically, by and In veterinary medicine, however, is a major pathogen responsible for bovine mastitis, which is a predominant form of protothecal disease in animals. Historically, identification of spp. Read More

Int J Dermatol 2018 10 30;57(10):1246-1248. Epub 2018 Mar 30.

Department of Dermatology, Dell Medical School at The University of Texas at Austin, Austin, TX, USA.

J Eur Acad Dermatol Venereol 2018 08 5;32(8):e327. Epub 2018 Mar 5.

Department of Dermatology, Affiliated Third Hospital of Hangzhou, Anhui Medical University, West Lake Rd 38, Hangzhou, Zhejiang, 310009, China.

J Eur Acad Dermatol Venereol 2018 Sep 12;32(9):1575-1583. Epub 2018 Feb 12.

Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

Background: Protothecosis is an uncommon infection caused by the achlorophyllic algae found more commonly in tropical areas. Only a limited number of cases have been reported.

Objective: We aimed to evaluate the clinicopathological features and treatment outcomes of cutaneous protothecosis. Read More

J Dermatol 2018 Jan 16;45(1):67-71. Epub 2017 Aug 16.

Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.

An 85-year-old Japanese woman presented with infiltrative erythema and ulceration on the extensor surface of her right forearm. Direct microscopic examination demonstrated spherical and morula-like sporangia, while histopathology revealed numerous microorganisms with a mulberry-like appearance in the dermis. Staining of the microorganisms also showed mulberry-like sporangia that resembled the spokes of a wheel. Read More

Med Mycol J 2017 ;58(2):E71-E77

Department of Dermatology, Kitasato University Kitasato Institute Hospital.

Understanding deep cutaneous fungal infection requires not only reading many case reports and checking the typical clinical images of skin lesions, but also managing the patients properly to prevent misdiagnosis. Herein, I review my recent experiences with eight typical cases of deep cutaneous infections (including protothecosis and nocardiosis) in Japan. It is very important to do the four management processes; namely, KOH direct microscopic examination, skin biopsy, fungal culture, and microscopic examination of the histopathological specimen of PAS and Grocott staining. Read More

Arkh Patol 2017;79(1):52-55

M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia.

The paper describes a case of a rare opportunistic infection, such as skin lesion caused by achlorophyllic unicellular algae of the genus Prototheca. It provides a detailed pathologic description of the foci of cutaneous protothecosis, such as pandermal inflammatory infiltrate, granulomas, pseudoepitheliomatous hyperplasia, and intraepidermal abscesses. Criteria for pathogen detection in histological sections are given. Read More

Pediatr Infect Dis J 2017 07;36(7):687-689

From the *Department of Laboratory Medicine, †Department of Pediatrics, and ‡Department of Neurosurgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Human protothecosis is mainly a cutaneous infection caused by the Prototheca species. Prototheca wickerhamii is an established pathogen of eosinophilic meningoencephalitis in dogs, but no eosinophilic pleocytosis of the cerebrospinal fluid has been reported in human cases of meningitis. Herein, we report a case of chronic protothecosis manifesting eosinophilic meningoencephalitis in an immunocompetent boy. Read More

Clin Exp Dermatol 2017 Jan;42(1):72-74

National Skin Centre, Singapore, Singapore.

Cutaneous protothecosis is caused by the achlorophyllic algae Prototheca, typically presenting as a localized plaque in immunocompetent individuals. We report a patient with bilateral erythematous plaques and pustules on her forearms, which had initially been treated with steroids for presumed eczema. Histology showed spherical spore-like bodies with internal morula-like septation, which were positive for periodic-acid-Schiff (PAS) staining, consistent with cutaneous protothecosis. Read More

Mycopathologia 2017 Jun 26;182(5-6):603-608. Epub 2016 Dec 26.

General Diagnostic Department, Istituto Zooprofilattico Sperimentale del Lazio e della Toscana "M. Aleandri", Via Appia Nuova 1411, 00178, Rome, Italy.

Protothecosis is a disease caused by saprophyte aerobic unicellular algae belonging to the genus Prototheca. In dogs, it mainly occurs as a disseminated form, with initial clinical manifestations often referable to the gastrointestinal tract, followed by typical ocular and neurological signs. So far, Prototheca zopfii genotype 2 infection has been reported in severe forms of disseminated protothecosis, while in dogs has never been associated with cutaneous forms. Read More

Int J Dermatol 2016 Dec 23;55(12):1373-1377. Epub 2015 Dec 23.

Department of Dermatology, Gil Medical Center, Gachon University School of Medicine, Incheon, South Korea.

Med Mycol Case Rep 2016 Jun 3;12:21-3. Epub 2016 Aug 3.

Westmead Hospital, Sydney 2145, Australia.

Protothecosis is a rare algal infection, affecting primarily immunocompromised hosts. Optimal management is unclear: in-vitro antimicrobial breakpoints are not established and therapeutic decisions are primarily based on case reports. We present a case of cutaneous Prototheca wickerhamii infection in an immunosuppressed 63 year old male, successfully treated with liposomal amphotericin and prolonged itraconazole. Read More