PDF(Pubmed)
Abstract：
Protothecosis, an infrequent human infection, is caused by achlorophyllic algae belonging to the genus Prototheca, particularly Prototheca wickerhamii. The skin stands as the most commonly affected organ. This report documents a case involving an 82-year-old male with Protothecosis. Histopathological analysis revealed granulomatous inflammation in the dermis, exhibiting necrotic features and hosting numerous non-budding spherical organisms. These organisms were positively stained using methenamine silver and periodic acid-Schiff stains, confirming identification as P. wickerhamii after validation through tissue culture and sequencing procedures. Initially, the patient received oral itraconazole at a dosage of 200 mg daily, accompanied by topical 1% naftifine-0.25% ketoconazole cream for a duration of 4 weeks, resulting in significant improvement. Subsequently, due to gastrointestinal discomfort presumably linked to itraconazole, terbinafine was administered. Over a span of 3 months, the patient received oral terbinafine at a dosage of 250 mg/day alongside the application of topical 1% naftifine-0.25% ketoconazole cream, leading to complete healing of the skin lesion, leaving behind a fibrotic scar.
摘要：
原样病,罕见的人类感染，是由无藻属的叶绿素藻类引起的，尤其是绿藻。皮肤是最常见的器官。本报告记录了一例涉及一名82岁男性原虫病的病例。组织病理学分析显示真皮肉芽肿性炎症，表现出坏死特征，并托管许多非出芽的球形生物。这些生物使用次甲基胺银和高碘酸希夫染色呈阳性，在通过组织培养和测序程序验证后，确认鉴定为威克哈姆氏杆菌。最初，患者口服伊曲康唑，剂量为每天200毫克，伴随着局部1％萘替芬-0.25％酮康唑乳膏持续4周，导致显著的改善。随后，由于胃肠道不适可能与伊曲康唑有关，服用特比萘芬。在三个月的时间里，患者口服特比萘芬，剂量为250毫克/天，同时外用1%萘替芬-0.25%酮康唑乳膏，导致皮肤病变完全愈合，留下纤维化疤痕.
