[Human protothecosis and environment]

Protothecosis are uncommon infections caused by Prototheca, considered to be achlorophylous algae. Nearly 80 human cases are reported in the literature since the first case described by Davies and Wakelin in 1964 in Sierra Leone (11). The disease have been identified in Europe, Asia (Japan, Thailand, China), Oceania and in the United States with 40 cases, particularly in the Southeast. Clinically, three clinical manifestations can be observed: 1) cutaneous lesions: papules, plaques or eczematoid, papulo-nodular areas of the extremities, 2) olecranon bursitis which occurred in 25% of cases, 3) systemic protothecosis. An immunosuppressive factor local or general can be found in half of the cases and the first description of algal meningitis was reported in a patient with AIDS in association with Cryptococcus neoformans. Because the disease is clinically not suspected, the diagnosis is often provided by histology showing a dermic granuloma with endospores. The characteristic feature of protothecosis in tissues is the presence of specific mature sporangia of Prototheca wickerhamii with the pattern of morula. The organism was PAS, Grocott and mucicarmin positive. The ecology was studied by Clark (7), Pidoux (23), Pore (25) and Sudman (27). Prototheca are ubiquitous inhabitants of sewages and are found in slime flux and animal wastes contaminating different aquatic systems. The transmission generally occurred by traumatic inoculation. Prototheca are also found in the digestive system of man and animals without never invasion of the epithelium and mucosae in experimental models. The pathogenicity and virulence are moderate and they are considered as rare opportunistic agents.