Skip to main content

Advertisement

SpringerLink
Log in

Cutaneous Protothecosis in Patient with Diabetes Mellitus and Review of Published Case Reports

  • Published:
Mycopathologia Aims and scope Submit manuscript

Abstract

Protothecosis is an opportunistic infection caused by Prototheca, usually called as saprophytes, and is frequently found in natural and living surroundings with low virulence, but may cause chronic infection in immunocompromised individuals. We report a case of cutaneous protothecosis with zopfii var. portoricensis infection in a 66-year-old diabetic woman following hand surgery on middle right finger. Mycology study showed that smooth, creamy white, yeast-like colonies grown after necrotic tissue was cultured on Sabouraud dextrose agar at both 37 and 25°C. The organism was then identified as Prototheca zopfii var. portoricensis by molecular identification and also found from histopathology of the lesion. The lesion got improved with intravenous amphotericin B and itraconazole.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Chao SC, Hsu MML, Lee JYY. Cutaneous protothecosis: report of five cases. Br J Dermatol. 2002;146:688–93.

    Google Scholar 

  2. DiPersio JR. Prototheca and protothecosis. Clin Microbiol Newsl. 2001;23:115–21.

    Article  Google Scholar 

  3. Shaoxi W, Guixia L, Yongnian S, Ningru G. The first case of Protothecosis Zopfii in China. Chin Med Sci J. 2000;15(2):121–3.

    Google Scholar 

  4. Cho BK, Ham SH, Lee JY, Choi JH. Cutaneous protothecosis. Int J Dermatol. 2002;41(5):304–6.

    Article  PubMed  Google Scholar 

  5. Sidrim JJC, Rocha MFG, Camara LMC, Brilhante RSN, Diogenes MJN, Oliveira AMA. Onycholysis caused by a mixed infection of Prototheca zopfii and Candida albicans. Clin Microbiol Newsl. 2003;25(9):69–71.

    Article  Google Scholar 

  6. Torres HA, Bodey GP, Tarrand JJ, Kontoyiannis DP. Protothecosis in patients with cancer: case series and literature review. Clin Microbiol Infect. 2003;9(8):786–92.

    Article  PubMed  CAS  Google Scholar 

  7. Zhao J, Liu W, Lv G, Shen Y, Wu S. Protothecosis successfully treated with amikacin combined with tetracyclines. Mycoses. 2004;47(3–4):156–8.

    Article  PubMed  CAS  Google Scholar 

  8. Leimann BC, Monteiro PC, Lazera M, Candanoza ER, Wanke B. Protothecosis. Med Mycol. 2004;42(2):95–106.

    Article  PubMed  Google Scholar 

  9. Zaitz C, Godoy AM, Colucci FM, De Sousa VM, Ruiz LRB, Masada AS, Nobre MV, Muller H. Cutaneous protothecosis: report of a third Brazilian case. Int J Dermatol. 2006;45(2):124–6.

    Google Scholar 

  10. Zaitz C, Miranda Godoy A, de Sousa VM, Ruiz LRB, Masada AS, Nobre MV. Onychoprotothecosis: report of the first case in Brazil. Int J Dermatol. 2006;45(9):1071–3.

    Google Scholar 

  11. Sheikh-Ahmad M, Goldstein S, Potasman I. Prototheca wickerhamii hand infection successfully treated by itraconazole and voriconazole. J Travel Med. 2006;13(5):321–3.

    Article  PubMed  Google Scholar 

  12. Hightower KD, Messina JL. Cutaneous protothecosis: a case report and review of the literature. Cutis. 2007;80(2):129–31.

    PubMed  Google Scholar 

  13. Narita M, Muder RR, Cacciarelli TV, Singh N. Protothecosis after liver transplantation. Liver Transpl. 2008;14(8):1211–5.

    Article  PubMed  Google Scholar 

  14. Humphrey S, Martinka M, Lui H. Cutaneous protothecosis following a tape-stripping injury. J Cutan Med Surg. 2009;13(5):273–5.

    PubMed  Google Scholar 

  15. Yamada N, Yoshida Y, Ohsawa T, Takahara M, Morino S, Yamamoto O. A case of cutaneous protothecosis successfully treated with local thermal therapy as an adjunct to itraconazole therapy in an immunocompromised host. Med Mycol. 2010;48(4):643–6.

    Article  PubMed  CAS  Google Scholar 

  16. Mathew LG, Pulimood S, Thomas M, Acharya MA, Raj PM, Mathews MS. Disseminated protothecosis. Indian J Pediatr. 2010;77(2):198–9.

    Article  PubMed  Google Scholar 

  17. Gaur S, Marrin C, Barnes RA. Disseminated protothecosis following traumatic Hickman line removal in a patient with leukaemia. Med Mycol. 2010;48(2):410–2.

    Article  PubMed  Google Scholar 

  18. Satoh K, Ooe K, Nagayama H, Makimura K. Prototheca cutis sp. nov., a newly discovered pathogen of protothecosis isolated from inflamed human skin. Int J Syst Evol Microbiol. 2010;60(Pt 5):1236–40.

    Google Scholar 

  19. González-Avila M, Gómez-Gómez JV, Espinosa Texis AP, Imbert-Palafox JL, Becerril-Flores MA, Blasco JL. Uncommon fungi isolated from diabetic patients toenails with or without visible onychomycoses. Mycopathologia. 2011;172(3):207–13.

    Article  PubMed  Google Scholar 

  20. Roesler U, Möller A, Hensel A, Banmann D, Truyen U. Diversity within the current algal species Prototheca zopfii: a proposal for two Prototheca zopfii genotypes and description of a novel species, Prototheca blaschkeae sp. Int J Syst Evol Microbiol. 2006;56:1419–25.

    Article  PubMed  CAS  Google Scholar 

  21. Satoh K, Ooe K, Nagayama H, Makimura K. Prototheca cutis sp. nov., a newly discovered pathogen of protothecosis isolated from inflamed human skin. Int J Syst Evol Microbiol. 2010;60(Pt 5):1236–40.

    Google Scholar 

  22. Cornelia LF, Manfred F, Eberhard G, Gastl G, Nachbaur D. Disseminated infection with Prototheca zopfii after unrelated stem cell transplantation for leukemia. J Clin Microbiol. 2004;42:4907–8.

    Article  Google Scholar 

  23. Iacoviello V, deGirolami P, Lucarini J, Sutker K, Williams ME,Wanke CA. Protothecosis complicating prolonged endotracheal intubation: case report and literature review. Clin Infect Dis. 1992;15:959–67.

    Google Scholar 

  24. Phair J, Williams J, Bassaris H, Zeiss C, Morlock B. Phagocytosis and algicidal activity of human polymorphonuclear neutrophils against Prototheca wickerhamii. J Infect Dis. 1981;144:72–7.

    Article  PubMed  CAS  Google Scholar 

  25. Carey WP, Kaykova Y, Bandres JC, Sidhu GS, Bräu N. Cutaneous protothecosis in a patient with AIDS and a severe functional neutrophil defect: successful therapy with amphotericin B. Clin Infect Dis. 1997;25:1265–6.

    Article  PubMed  CAS  Google Scholar 

  26. Krcme’ry VJ. Systemic chlorellosis, an emerging infection in humans caused by algae. Int J Antimicrob Agents. 2000;15:235–7.

  27. Sirikulchayanonta V, Visuthikosol V, Tanphaichitra D, Prajaktham K. Protothecosis following hand injury. A case report. J Hand Surg. 1989;14:88–90.

    Article  CAS  Google Scholar 

  28. Zhang Q-Q, Zhu L-P, Weng X-H, Li L, Wang J-J. Meningitis due to Prototheca wickerhamii: rare case in China. Med Mycol. 2007;45:85–8.

    Google Scholar 

  29. Zhang Q, Weng X, Li L, Zhu L, Yu S, Chen S, Xiang Y, Wan H, Ran Y, Kang K. An unusual case of granulomatous lymphadenitis due to P. zopf ii var. portoricensis in an immunocompetent man in China. Int J Infect Dis. 2010;14S:e32–5.

    Google Scholar 

Download references

Acknowledgments

We appreciate the assistance of Drs. Sung-Oui Suh and Jianlong Jim Zhou at ATCC (American Type Culture Collection) for DNA sequencing and molecular analysis.

Author information

Authors and Affiliations

  1. The Center for Medical Mycology, Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, People’s Republic of China

    Qiang-Qiang Zhang, Li Li, Ying Zhao, Yun-Ru Wang, Jun-hao Zhu & Min Zhu

  2. Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, 200040, People’s Republic of China

    Li-Ping Zhu

Authors
  1. Qiang-Qiang Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Li Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Li-Ping Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ying Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yun-Ru Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jun-hao Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Min Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Qiang-Qiang Zhang.

Additional information

Qiang-Qiang Zhang and Li Li have contributed equally to this paper.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhang, QQ., Li, L., Zhu, LP. et al. Cutaneous Protothecosis in Patient with Diabetes Mellitus and Review of Published Case Reports. Mycopathologia 173, 163–171 (2012). https://doi.org/10.1007/s11046-011-9480-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11046-011-9480-0

Keywords

Search

Navigation