BACKGROUND: Human protothecosis is an uncommon infection caused by Prototheca spp that rarely infects humans.
OBJECTIVE: Description of a rare disease and a review of its articles.
METHODS: We reported a 24-year-old man who presented with red-brown papules and plaques on the trunk\'s lateral side. We reviewed the literature about disseminated protothecosis and reported our experience with a patient with protothecosis between 2021 and 2023.
RESULTS: Overall, 54 cases of disseminated protothecosis were evaluated, 39 were due to P. wickerhamii, 12 were due to P. zopfii (22.2%), and three were due to Prototheca spp. We found that males were more affected (37 cases, 68.5%) than females (16 cases, 29.6%). The mean age of patients was 39.53 ± 22.48 years. However, disseminated protothecosis can affect people of any age (1-80 years). In contrast to P. wickerhamii, which causes blood, skin, brain, and gastrointestinal tract infections, P. zopfii was mainly found in the blood (7/22) and did not have a significant difference in the mortality rate (P = 0.11).
CONCLUSIONS: Disseminated protothecosis is a rare disease in immunocompromised patients but is generally rarer in immunocompetent hosts. Several underlying disorders include immunocompromised patients, prolonged application of steroids, diabetes mellitus, malignancies, organ transplantation, AIDS, and surgeries. Amphotericin B has been the most effective agent for protothecosis and is reserved for visceral and disseminated infections. Regarding localized cutaneous types, excision or surgical debridement is used.
CONCLUSIONS: Mulberry\'s appearance and appropriate cultural environments are helpful in diagnosing it.

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.

BACKGROUND: Protothecosis is an infection of humans and animals caused by a rare conditionally pathogenic fungus (prototheca). It can occur in immunocompromised or normal patients.
OBJECTIVE: To describe the epidemiology of prototheca infection in China.
METHODS: We report a case of successful treatment of cutaneous protothecosis with fluconazole and analyzed the epidemiological characteristics, risk factors, clinical manifestations, diagnosis, treatment and prognosis of prototheca infections in China.
RESULTS: We describe this case and 29 cases of prototheca infections in China. At present, Prototheca wickerhamii (Pw) infection is the most common infection in China, and single or combined itraconazole is the preferred treatment.
CONCLUSIONS: These results provide detailed information and relevant clinical treatment strategies for the diagnosis and treatment of protothecosis in China.

暂无摘要。

UNASSIGNED: Medical records of four dogs diagnosed with protothecosis in New Zealand were reviewed. The dogs were aged between 4 and 9 years and three of the four dogs were female. Breeds were one Labrador, one Miniature Schnauzer and two crossbreeds. The reasons for initial veterinary evaluation were a cough and opaque appearance of the right eye (Case 1), diarrhoea (Cases 2 and 3), and cutaneous disease (Case 4).
UNASSIGNED: The ocular signs were characterised by panuveitis, retinal detachment and secondary glaucoma. Gastrointestinal signs included chronic haemorrhagic diarrhoea due to colitis. Three cases had disseminated infection and developed both bilateral, blinding, ocular disease and chronic gastrointestinal disease. Cutaneous signs consisted of draining fistulae over the olecranon, multifocal cutaneous nodules, and ulceration and tracts of the foot pads. Disseminated protothecosis was confirmed by histopathology of biopsied ocular tissues in Cases 1 and 2 and by gastrointestinal biopsies in Case 3. Prototheca spp. were also identified in cytological specimens from Cases 1 and 4 and recovered by culture in Cases 2 and 4. Cutaneous protothecosis was diagnosed in Case 4 initially by cytology and histopathology of skin lesions, and Prototheca zopfii was confirmed by PCR of cultured organisms.
UNASSIGNED: Prior to diagnosis of protothecosis, a variety of treatments were prescribed to treat the gastrointestinal and ocular signs. After diagnosis, only Cases 2 and 4 received medication aimed at treating the protothecal infection, which was itraconazole in both cases. Following the progression of clinical signs and concerns about quality of life, all four dogs were euthanised.
UNASSIGNED: Disseminated protothecosis in three dogs, cutaneous protothecosis in one dog.
UNASSIGNED: Canine protothecosis is rarely reported, despite the ubiquity of the causal algae, and the disease usually carries an extremely grave prognosis when infection is generalised. In New Zealand, protothecosis should be considered as a differential diagnosis in dogs with panuveitis, chorioretinitis or retinal detachment, colitis, or nodular, ulcerative or fistulating cutaneous lesions.

A domestic cat was presented with nodular lesions on the nose/muzzle and pinnae. Protothecosis was diagnosed through cytological and histopathological examination, and culture. Molecular identification confirmed Prototheca wickerhamii infection. Intralesional application of amphotericin B in conjunction with oral terbinafine resulted in a significant reduction of the nasal lesion and complete resolution of the pinnal lesion, without adverse effects.
一只家猫的鼻子/口周和耳廓出现结节性病变。通过细胞学、组织病理学检查和培养，诊断出原藻病。分子鉴定证实了魏氏原壁菌感染。应用两性霉素B联合特比萘芬口服，病灶内可见鼻腔病变显著减少，并完全消除耳廓病变，无不良药物反应。.
Un chat domestique est présenté avec des lésions nodulaires sur le nez/museau et le pavillon auriculaire. La protothécose est diagnostiquée par un examen cytologique et histopathologique, ainsi que par une culture. L\'identification moléculaire confirme l\'infection par Prototheca wickerhamii. L\'application intralésionnelle d\'amphotéricine B, associée à la terbinafine orale, permet une réduction significative de la lésion nasale et une résolution complète de la lésion du pavillon auriculaire, sans effets indésirables.
Eine Hauskatze wurde mit knotigen Läsionen auf der Nase/dem Maul und an den Pinnae vorgestellt. Mittels zytologischer und histopathologischer Untersuchung und einer Kultur wurde eine Protothekose diagnostiziert. Mittels molekularer Identifizierung wurde eine Infektion mit Prototheca wickerhamii bestätigt. Eine intraläsionale Verabreichung von Amphotericin B in Kombination mit Terbinafin per os resultierte in einer signifikanten Verbesserung der Nasenläsionen und einer völligen Abheilung der Läsionen an den Pinnae, ohne dass Nebenwirkungen auftraten.
鼻/マズルおよび耳介に結節性病変を有する家猫が受診した。細胞学的検査、病理組織学的検査および培養検査によりProtothecosisと診断した。分子生物学的同定によりPrototheca wickerhamii感染が確認された。アムホテリシンBの鼻腔内投与およびテルビナフィンの経口投与を併用した結果、鼻病変は有意に縮小し、耳介病変は副作用なく完全に消失した。.
Um gato doméstico foi apresentado com lesões nodulares no nariz/focinho e pavilhões auriculares. Prototecose foi diagnosticada por exame citológico e histopatológico, e cultura. A identificação molecular confirmou a infecção por Prototheca wickerhamii. Aplicação intralesional de anfotericina B associada à terbinafina por via oral resultou em redução significativa da lesão nasal e resolução total da lesão na orelha, sem efeitos adversos.
Un gato doméstico se presentó con lesiones nodulares en la nariz/hocico y orejas. Se diagnosticó prototecosis mediante examen citológico, histopatológico y cultivo. La identificación molecular confirmó la infección por Prototheca wickerhamii. La aplicación intralesional de anfotericina B junto con terbinafina oral dio como resultado una reducción significativa de la lesión nasal y una resolución completa de la lesión auricular, sin efectos adversos.

Prototheca is a microalgae known to cause infections in humans, with protothecosis most commonly presenting as olecranon bursitis or localized soft tissue infection. Disseminated disease can be seen in immunocompromised patients. In this retrospective single-institution case series, we describe our experience with 7 patients with Prototheca infections.

Protothecosis is an important infection caused by Prototheca spp., an alga that affect humans and animals. Prototheca spp. infections determine losses of production and quality of life for the affected animals. In this disease, prevention and early diagnosis are essential to avoid the spread of the agent to susceptible hosts. This review aimed to assemble the reported cases of protothecosis in Veterinary Medicine, highlighting Prototheca species involved in the infections, the main animal species affected, as well as the clinical manifestations, diagnosis, and treatment. Our findings showed that protothecosis has been reported in various domestic and wild animal species, presenting diverse clinical manifestations, including mastitis in cows, respiratory manifestations in goats and cats, and a wide range of clinical signs in dogs. The clinical diagnosis and treatment of Prototheca spp. infections are difficult and infected animals are frequently discarded or euthanized. Due to the importance of this infection, protothecosis must be considered an important differential diagnosis in routine clinical Veterinary Medicine.

暂无摘要。

Prototheca species are the only microalgae known to cause opportunistic infections in vertebrates and humans. Most cases of protothecosis in humans are caused by Prototheca wickerhamii, but knowledge of the pathogenicity and biology of Prototheca is limited. Globally, the diagnostic rate of Prototheca species infection is much lower than the actual rate of P. wickerhamii. The precise mechanisms underlying the pathogenesis of Prototheca infections remain unclear. In this study, we identified a strain of P. wickerhamii with atypical colony morphology. To reveal the morphological differences between P. wickerhamii S1 (mucous) and the molecular basis of its pathogenicity, the transcriptomics, proteomics, and metabolomics of two pathogenic P. wickerhamii strains and one environmental strain were analysed. Interestingly, mannan endo-1,4-β-mannosidase was significantly downregulated in P. wickerhamii S1, which contributes to a thinner cell wall in S1 compared to strains with typical colony morphology, and the toxicity of macrophages is reduced. Metabolite analysis revealed that the mucoid appearance of P. wickerhamii S1 may have been caused by an increase in linoleic acid, glycerol, and other metabolites. There is still a need to better understand the ecology, aetiology, and pathogenesis of P. wickerhamii, and in particular, its transmission between humans, animals, and the environment, from a One Health perspective.