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Transplant Proc 2018 Aug 10. Epub 2018 Aug 10.

Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary.

Introduction: The Prototheca species are achlorophyllic algae and they are recognized pathogens in animals. They have been reported to cause infections in humans; the majority of the infected patients are immunocompromised. Organ transplant recipients are at risk of infection caused by such unusual organisms. 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 Oct 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

J Clin Microbiol 2018 Aug 26;56(8). Epub 2018 Jul 26.

Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA

Mycopathologia 2018 Jun 6. Epub 2018 Jun 6.

Instituto Nacional de Investigación Agropecuaria (INIA), Ruta No. 50, km 11, La Estanzuela, Colonia, 70006, Uruguay.

Protothecosis is a rare disease caused by environmental algae of the genus Prototheca. These are saprophytic, non-photosynthetic, aerobic, colorless algae that belong to the Chlorellaceae family. Seven different species have been described. Read More

Med Mycol 2018 Apr;56(suppl_1):S188-S204

Department of Medical Microbiology, Immunology, and Cell Biology, West Virginia University School of Medicine, Morgantown, West Virginia, USA.

In 2014, ISHAM formed a new working group: "Medical Phycology: Protothecosis and Chlorellosis." The purpose of this working group is to help facilitate collaboration and communication among people interested in the pathogenic algae, to share ideas and work together. Here we present reports on recent work we have done in five areas. Read More

Front Pharmacol 2018 19;9:375. Epub 2018 Apr 19.

Department of Genetics, Institute of Genetics and Microbiology, University of Wroclaw, Wroclaw, Poland.

is an unusual infection of both humans and animals caused by opportunistically pathogenic microalgae of the genus . Until now, no standardized treatment protocols exist for the protothecal disease, boosted by a remarkable resistance of spp. to a wide array of antimicrobial agents currently available in clinical use. Read More

J Mycol Med 2018 Jun 16;28(2):300-304. Epub 2018 Apr 16.

Department of environmental biology, Medical University of Lodz, Żeligowskiego 7/9, 90752 Lodz, Poland.

The research concerns algae of the genus Prototheca. They are found in the natural environment and they can cause a disease in animals and humans called protothecosis. The aim of the study was to evaluate the in vitro activity of the fruit and vegetable rinse agent SunSmile Fruit & Vegetable Rinse (Sunrider International) against P. Read More

J Infect Dis 2018 Jul;218(3):485-489

Department of Pathology, Yale University School of Medicine, New Haven, Connecticut.

Human protothecosis is a rare microalgae infection, and its dissemination typically occurs in immunocompromised individuals, but no specific immune defect has been reported. Here, we describe an 8-year-old daughter of a consanguineous union with abdominal pain and bloody diarrhea for 3 months who was found to have pancolitis with numerous microalgae identified as Prototheca zopfii. In the absence of a known immunodeficiency, exome sequencing was performed, which uncovered a novel recessive frameshift mutation in CARD9 (p. 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 Feb 14. Epub 2018 Feb 14.

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

Infect Chemother 2017 Dec;49(4):293-296

Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea.

Protothecosis is an uncommon human infection caused by achlorophyllic algae of the genus Prototheca, especially P. wickerhamii. The skin is the most frequently involved organ and cases of protothecal tenosynovitis are very rare. Read More

J Zoo Wildl Med 2017 Dec;48(4):1260-1263

An adult male Ruwenzori long-haired fruit bat ( Rousettus lanosus) presented for lethargy and unthriftiness. Physical examination revealed cranial alopecia, mandibular ulceration, and dehydration. Supportive care and antibiotic therapy were initiated. 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

Rev Argent Microbiol 2017 Jul - Sep;49(3):224-226. Epub 2017 May 27.

Universidad Nacional del Nordeste, CONICET, Instituto de Medicina Regional, Departamento de Micología, Resistencia, Chaco, Argentina.

Human protothecosis is a rare infection caused by algae of the genus Prototheca. Prototheca wickerhamii has been recognized as the main species that causes infection in immunocompromised hosts with deficits in innate or cellular immunity. We report a case of persisting subcutaneous protothecosis in a patient with T-cell large granular lymphocyte leukemia, who also presented a history of disseminated histoplasmosis. Read More

Med Mycol 2018 Apr;56(3):279-287

Department of Microbiology, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan.

In this study, six strains of Prototheca isolated in China from human patients diagnosed as protothecosis and cows with mastitis were characterized by polymerase chain reaction (PCR) and nucleotide sequencing of the ribosomal RNA gene (rDNA) and by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS). The results indicated that three strains isolated from the human patients were P. zopfii genotype 1, revealing the first cases of human protothecosis associated with P. Read More

JFMS Open Rep 2017 Jan-Jun;3(1):2055116916688590. Epub 2017 Jan 1.

Centre for Veterinary Education, The University of Sydney, Sydney, Australia.

Case Summary: A 16-year-old, castrated male, feline immunodeficiency virus (FIV)-positive, domestic shorthair cat developed multiple skin lesions. Most of these were Bowenoid carcinoma in situ and contained DNA sequences consistent with papillomavirus type 2. Two additional lesions that developed in the skin and subcutaneous tissues between the digital and carpal pads on the left forelimb and right hindlimb were shown by cytology, histology and culture to be caused by . Read More

Lett Appl Microbiol 2017 Jun 3;64(6):419-423. Epub 2017 May 3.

Department of Veterinary Hygiene and Public Health, UNESP-São Paulo State University, Botucatu, SP, Brazil.

Prototheca species have increasingly been reported to be opportunistic pathogens that cause mastitis in dairy herds, and it poses an emergent problem because at present, there are no effective therapies for the treatment of protothecal mastitis. This study investigated the in vitro algicidal effect of guanidine on 75 Prototheca zopfii genotype 2 strains isolated from 75 cases of clinical and subclinical bovine mastitis. All strains were susceptible to guanidine in vitro with minimal algaecide concentrations ranging from 0·001 to 0·035%. Read More

J Fish Dis 2017 Oct 16;40(10):1417-1421. Epub 2017 Mar 16.

Institute of Animal Hygiene and Environmental Health, Centre for Infectious Medicine, Freie Universität Berlin, Berlin, Germany.

Protothecosis is a rare infection caused by environmentally ubiquitous achlorophyllic microalgae of the genus Prototheca. Here, we describe a first case of protothecosis in a carp (Cyprinus carpio), which is at the same time the first case of protothecosis in a fish, confirmed by phenotype- and molecular-based methods, including PCR sequencing of the rDNA cluster and protein profiling using matrix-assisted laser desorption ionization time-of-flight mass spectrometry. 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

Int J Mol Sci 2016 Dec 29;18(1). Epub 2016 Dec 29.

Institute of Animal Hygiene and Environmental Health, Centre for Infectious Medicine, Freie Universität Berlin, Robert-von-Ostertag-Str. 7-13, 14163 Berlin, Germany.

Microalgae of the genus () spp are associated with rare algal infections of invertebrates termed protothecosis. Among the seven generally accepted species, genotype 2 (GT2) is associated with a severe form of bovine mastitis while causes the mild and sub-clinical form of mastitis. The reason behind the infectious nature of GT2, while genotype 1 (GT1) remains non-infectious, is not known. 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

Cornea 2016 Sep;35(9):1257-60

*Gavin Herbert Eye Institute, University of California Irvine, Irvine, CA; †Pathology Department, UCI Medical Center, Orange, CA; Departments of ‡Medicine; §Pediatrics; and ¶Microbiology and Immunology, New York Presbyterian Hospital, Weill Cornell Medicine of Cornell University, New York, NY.

Purpose: To report a case of recalcitrant Prototheca spp. keratitis and endophthalmitis in a patient with Stevens-Johnson syndrome (SJS) and Boston type 1 keratoprosthesis (B1 KPro).

Methods: Case report. Read More

Histopathology 2016 Dec 9;69(6):1082-1084. Epub 2016 Aug 9.

Division of Neuropathology, Institute for Pathology, Basel University Hospital, Basel, Switzerland.

Ann Dermatol 2016 Apr 31;28(2):273-4. Epub 2016 Mar 31.

Department of Dermatology, Ewha Womans University School of Medicine, Seoul, Korea.

Mycopathologia 2016 Aug 4;181(7-8):609-15. Epub 2016 Mar 4.

Environmental Biology Department, Medical University of Lodz, Żeligowskiego 7/9, 90-752, Lodz, Poland.

Background: The algae of the genus Prototheca are environmental pathogens whose main reservoir is the habitat of cows. They can cause protothecosis in domestic and wild animals, as well as human beings, with the main etiological agents being Prototheca zopfii in animals and Prototheca wickerhamii in humans.

Aim: The aim of the study was to evaluate the in vitro activity of selected essential oils and antifungal antibiotics against P. Read More

Case Rep Vet Med 2016 29;2016:2878751. Epub 2016 Feb 29.

Quality Veterinary Practice, 383 33 Volos, Greece.

is ubiquitous, saprophytic achlorophyllous algae that cause opportunistic infections in the dog and cat and disseminated disease usually in immunocompromised animals. In this report an uncommon case of canine cutaneous protothecosis is presented. A 6-year-old female boxer was brought in with skin lesions that consisted of nodules and generalized footpad hyperkeratosis, depigmentation, and erosion. Read More

Int J Syst Evol Microbiol 2016 Mar 19;66(3):1510-1520. Epub 2016 Jan 19.

1​Department of Microbiology, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan.

Species of the genus Prototheca are achlorophyllous algae and ubiquitous in nature, and so far, six species have been listed in this genus: Prototheca wickerhamii, Prototheca zopfii, Prototheca blaschkeae, Prototheca cutis, Prototheca stagnora and Prototheca ulmea. A strain of the genus Prototheca, IFM 53848T, was isolated in Japan from a patient with systemic protothecosis and had been designated P. wickerhamii. Read More

Transpl Infect Dis 2016 Apr 22;18(2):266-74. Epub 2016 Feb 22.

Department of Pathology, Hospital Pablo Tobón Uribe, Dinámica IPS, Medellín, Colombia.

Solid organ transplantation is an accepted therapy for end-stage diseases of the kidneys, liver, heart, and lungs. Unfortunately, transplantation is associated with infectious complications. Here, we present a case report of Prototheca wickerhamii olecranon bursitis and review all of the cases in solid organ transplant (SOT) recipients published in the literature to date. Read More

Int J Dermatol 2016 Feb 24;55(2):e59-61. Epub 2015 Oct 24.

Department of Dermatology, Cleveland Clinic, Cleveland, OH, USA.

Front Cell Infect Microbiol 2015 29;5:67. Epub 2015 Sep 29.

Institute of Animal Hygiene and Environmental Health, Centre for Infection Medicine, Freie Universität Berlin Berlin, Germany.

Microalgae of the genus Prototheca (P.) are associated with rare but severe infections (protothecosis) and represent a potential zoonotic risk. Genotype (GT) 2 of P. Read More

Med Mycol J 2015 ;56(3):J93-7

Department of Pathobiology, Nihon University School of Veterinary Medicine.

Protothecosis is an emerging infectious zoonotic disease caused by species of the genus Prototheca (Trebouxiophyceae, Chlorophyta), which are classified as achlorophyllous algae closely related to the green algal genus Chlorella. Prototheca lost the ability to photosynthesize and are widely distributed throughout the natural world in sewage, soil, lakes, and marshes. It is therefore necessary to build an interdisciplinary network connecting human medicine, veterinary medicine, microbiological taxonomy, clinical microbiology, and environmental microbiology to increase knowledge in this area. Read More

Indian J Med Microbiol 2015 Jul-Sep;33(3):435-7

Department of Microbiology, Padmashree Dr. Dnyandeo Yashwantrao Patil Medical College, Hospital and Research Centre, Pune - 411 018, Maharashtra, India.

Onychomycosis is a fairly common condition seen in a dermatology clinic. Dermatophytes Trichophyton and Epidermophyton are the known filamentous fungi implicated. The yeast-like fungi such as Candida less commonly cause Onychomycosis. Read More

Transpl Infect Dis 2015 Aug 7;17(4):599-604. Epub 2015 Jul 7.

Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, USA.

Prototheca wickerhamii is an alga that rarely causes human disease but has been reported increasingly among immunocompromised individuals. We report a fatal case of P. wickerhamii in a renal transplant recipient who presented with a cutaneous lesion that led to disseminated disease despite treatment with voriconazole. Read More

Eur J Dermatol 2015 Apr;25(2):208-9

Department of Dermatology.

J Comp Pathol 2015 May 23;152(4):287-90. Epub 2015 Mar 23.

Institute of Pathology, Faculty of Veterinary Medicine, University of Leipzig, An den Tierkliniken 33, Leipzig, Germany. Electronic address:

Few published cases of feline protothecosis exist; all of these were restricted to the skin and speciation of the causative organism revealed an infection with Prototheca wickerhamii in each case. This report describes Prototheca zopfii genotype 2-induced inflammation of the nasal skin and cutaneous mucosa of the right nostril in a 14-year-old neutered female domestic shorthair cat. Microscopical examination revealed marked pyogranulomatous inflammation with numerous intralesional algae. Read More

New Microbes New Infect 2015 Jan 8;3:37-40. Epub 2014 Nov 8.

Institute of Animal Hygiene and Environmental Health, Centre for Infection Medicine, Germany.

Prototheca zopfii associated with bovine mastitis and human protothecosis exists as two genotypes, of which genotype 1 is considered as non-infectious and genotype 2 as infectious. The mechanism of infection has not yet been described. The present study was aimed to identify genotype 2-specific immunodominant proteins. Read More

J Dairy Sci 2015 May 26;98(5):3001-9. Epub 2015 Feb 26.

Centro de Investigação em Biodiversidade e Recursos Genéticos Universidade do Porto (CIBIO/UP), InBio Laboratório Associado Campus Agrário de Vairão, Rua Padre Armando Quintas, n 7, 4485-661 Vairão, Portugal; Laboratório de Doenças Infecciosas do Departamento de Clínicas Veterinárias, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Rua de Jorge Viterbo Ferreira, n 228, 4050-313 Porto, Portugal.

The increasing incidence of rare mastitis-causing pathogens has urged the implementation of fast and efficient diagnostic and control measures. Prototheca algae are known to be associated with diseases in humans and animals. In the latter, the most prevalent form of protothecosis is bovine mastitis with Prototheca zopfii and Prototheca blaschkeae representing the most common pathogenic species. Read More

J Glob Infect Dis 2015 Jan-Mar;7(1):40-2

Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute, Cleveland, Ohio, USA.

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. Read More

J Fungi (Basel) 2015 Jan 14;1(1):4-12. Epub 2015 Jan 14.

Department of Dermatology, Baylor College of Medicine, 1977 Butler Blvd, Suite E6.200, Houston, TX 77030, USA.

Protothecosis is a rare infection, which has the potential to cause severe disease in patients with underlying immunosuppression. We describe a case of an elderly female with chronic lymphocytic leukemia (CLL), as well as other risk factors, who presented with pustular and erythematous plaques, initially presumed to be leukemia cutis. A biopsy with special stains revealed the lesions to be cutaneous protothecosis, thus presenting a most unusual concurrence of disease entities. Read More

Clin Infect Dis 2014 Dec;59(12):iv

New Microbes New Infect 2014 Nov;2(6):156-60

Department of Paediatric Haematology and Oncology, Haematopoietic Stem Cell Transplantation Unit, Comenius University Children's Hospital Bratislava, Slovakia.

The case presented here illustrates a protothecal infection caused by Prototheca wickerhamii in a paediatric haematopoietic stem cell recipient followed by a review of the literature of all 13 paediatric cases published since 1980. Protothecosis is a rare disease caused by algae, not described in this setting before. Infection was proven additionally post-mortem from peritoneal dialysis fluid. Read More

Vet Ophthalmol 2015 Sep 17;18(5):437-42. Epub 2014 Dec 17.

Comparative Ocular Pathology Laboratory of Wisconsin, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI, 53706, USA.

Purpose: To examine a series of 14 cases of canine ocular protothecosis from archived cases from the Comparative Ocular Pathology Laboratory of Wisconsin (COPLOW), and compare gross and histologic findings.

Methods: Archival records from COPLOW were searched for canine cases of ocular protothecosis. Fourteen cases that contained matching criteria were identified, and gross and histologic findings, and clinical records for each case were tabulated, examined, and compared (2001-2013). Read More

New Microbiol 2014 Oct 1;37(4):459-64. Epub 2014 Oct 1.

Department of Veterinary Medicine, University of Bari, Aldo Moro, Casamassima, Bari, Italy.

Protothecosis is a potential zoonotic disease associated with bovine mastitis which can be transmitted to humans through contaminated milk. Considering the increasing prevalence of bovine mastitis due to Prototheca species, individual cow milk samples were analyzed using microbiological examination and biomolecular assay. Aspects related to health requirements for milk production, clinical and histological bovine mastitis were also described. Read More