Human Disseminated Protothecosis: The Skin is the "Window"?

Area of Science:

• Medical Mycology
• Infectious Diseases
• Dermatology

Background:

• Human disseminated protothecosis is a rare infection caused by achlorophyllic algae of the genus *Prototheca*.
• Infection typically affects debilitated hosts and is often misdiagnosed due to non-specific clinical features and low clinician awareness.
• Histological identification relies on observing non-budding cells, sporangia, and endosporulation (morula).

Purpose of the Study:

• To review the etiological, epidemiological, and clinical aspects of disseminated protothecosis.
• To analyze species-specific differences in pathogenicity and clinical presentation between *P. zopfii* and *P. wickerhamii*.
• To underscore the importance of considering protothecosis, especially with skin manifestations, in immunocompromised patients.

Main Methods:

• Literature review summarizing existing data on disseminated protothecosis.
• Analysis of etiological factors, epidemiological trends, and clinical manifestations.
• Comparison of clinical differences and pathogenicity between *Prototheca* species.

Main Results:

• The skin is identified as the primary site of invasion and the most affected organ in disseminated protothecosis.
• Clinical differences and potential pathogenicity variations between *P. zopfii* and *P. wickerhamii* were noted.
• Limited species-specific data currently exists for this infection.

Conclusions:

• Disseminated protothecosis is an emerging concern, particularly with the rising global population of immunocompromised individuals.
• Clinicians should consider protothecosis in the differential diagnosis, especially when skin symptoms are present.
• Further research into species-specific aspects is needed to improve diagnosis and management.