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Multiple cutaneous infections caused by Prototheca wickerhamii.

Feng Zhao¹, Miaode Chen², Ying Fu¹

¹Department of Clinical Laboratory, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Journal of Clinical Laboratory Analysis

|July 22, 2020

Summary

Prototheca wichehamii caused a rare skin infection in an elderly diabetic patient. This yeast-like fungus showed resistance to common antifungals but was treatable with amphotericin B and other specific agents.

Keywords:

Prototheca wickerhamii cutaneous infection identification susceptibility treatment

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Area of Science:

Medical Mycology
Clinical Microbiology
Infectious Diseases

Background:

Prototheca species are ubiquitous environmental organisms that can cause opportunistic infections in humans.
Accurate species identification and antifungal susceptibility testing are crucial for effective clinical management of Prototheca infections.
Cutaneous protothecosis, though rare, poses a public health concern, necessitating attention to diagnostic and therapeutic strategies.

Observation:

An 84-year-old patient with type II diabetes mellitus presented with multiple cutaneous infections.
Microscopic examination of skin tissue revealed round, grape-like, and scattered morula forms characteristic of Prototheca.
Microbial cultures grew yeast-like colonies on blood and Sabouraud agar.

Findings:

Species identification confirmed Prototheca wichehamii.
Antifungal susceptibility testing indicated resistance to echinocandins, fluconazole, and 5-fluorocytosine.
The isolate remained susceptible to amphotericin B, posaconazole, itraconazole, and voriconazole.

Implications:

Elderly patients with diabetes mellitus may be a vulnerable population for cutaneous protothecosis.
Advanced diagnostic methods, including molecular identification, are vital for diagnosing rare fungal infections.
Understanding antifungal resistance patterns is essential for guiding treatment decisions in complex cases of protothecosis.