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Protothecosis in a patient with systemic lupus erythematosus
1Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Internal Medicine (Tokyo, Japan)
|July 1, 1993
Summary
A rare skin infection, protothecosis, occurred in an immunocompromised woman with systemic lupus erythematosus. Treatment with amphotericin B successfully resolved the extensive ulcerative lesions caused by Prototheca wicherhamii.
Area of Science:
- Medical Mycology
- Dermatology
- Immunology
Background:
- Protothecosis is a rare opportunistic infection caused by Prototheca species, often occurring in immunocompromised individuals.
- Systemic lupus erythematosus (SLE) is an autoimmune disease that frequently requires immunosuppressive therapy, increasing infection risk.
- Long-term corticosteroid treatment, like prednisolone, can exacerbate immune deficiency.
Observation:
- A 40-year-old Japanese woman with SLE on long-term prednisolone developed extensive ulcerative skin lesions post-injury.
- Histopathological examination revealed characteristic findings consistent with Prototheca infection.
- Biochemical sugar assimilation tests identified the causative agent as Prototheca wicherhamii.
Findings:
- The patient's immunodeficient state, due to SLE and prednisolone treatment, was a significant contributing factor to the development of protothecosis.
- Antifungal therapy with amphotericin B led to the improvement of the ulcerative skin lesions.
- This case highlights the importance of considering rare infections in immunocompromised patients.
Implications:
- Early diagnosis and appropriate antifungal treatment are crucial for managing protothecosis.
- Understanding the role of host immune status in opportunistic infections is vital for clinical practice.
- Further research into Prototheca species and their pathogenesis in immunocompromised hosts is warranted.