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Disseminated Protothecosis: Case Report and Review of the Literature Publisher Pubmed



Shakoei S1, 2 ; Mohamadi F2 ; Ghiasvand F3 ; Khosravi AR4 ; Kamyab K5 ; Salahshour F6
Authors
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Authors Affiliations
  1. 1. Department of Dermatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS), Tehran, Iran
  2. 2. Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
  3. 3. Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences (TUMS), Tehran, Iran
  4. 4. Department of Microbiology and Immunology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
  5. 5. Department of Pathology, Razi Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
  6. 6. Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences (TUMS), Tehran, Iran

Source: Journal of Cutaneous Pathology Published:2024


Abstract

Background: Human protothecosis is an uncommon infection caused by Prototheca spp that rarely infects humans. Aim: Description of a rare disease and a review of its articles. Materials and Methods: We reported a 24-year-old man who presented with red-brown papules and plaques on the trunk's lateral side. We reviewed the literature about disseminated protothecosis and reported our experience with a patient with protothecosis between 2021 and 2023. Results: Overall, 54 cases of disseminated protothecosis were evaluated, 39 were due to P. wickerhamii, 12 were due to P. zopfii (22.2%), and three were due to Prototheca spp. We found that males were more affected (37 cases, 68.5%) than females (16 cases, 29.6%). The mean age of patients was 39.53 ± 22.48 years. However, disseminated protothecosis can affect people of any age (1–80 years). In contrast to P. wickerhamii, which causes blood, skin, brain, and gastrointestinal tract infections, P. zopfii was mainly found in the blood (7/22) and did not have a significant difference in the mortality rate (P = 0.11). Discussion: Disseminated protothecosis is a rare disease in immunocompromised patients but is generally rarer in immunocompetent hosts. Several underlying disorders include immunocompromised patients, prolonged application of steroids, diabetes mellitus, malignancies, organ transplantation, AIDS, and surgeries. Amphotericin B has been the most effective agent for protothecosis and is reserved for visceral and disseminated infections. Regarding localized cutaneous types, excision or surgical debridement is used. Conclusion: Mulberry's appearance and appropriate cultural environments are helpful in diagnosing it. © 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.