Protothecal olecranon bursitis: treatment with intrabursal amphotericin B

A patient is described from whom repeated olecranon bursa fluid cultures yielded Prototheca wickerhamii. Following intrabursal instillation of amphotericin B, the cultures became negative. There was no progression of infection or adverse consequences of this treatment. Review of the literature regarding this unusual infection reveals seven reported cases of protothecal olecranon bursitis. Five cases from which sufficient information was provided were diagnosed by histologic examination of excised bursa that showed the characteristic sporangia.