Prototheca wickerhamii cutaneous and systemic infections

Abstract

Prototheca wickerhamii, an environmental alga, rarely causes human infections. We present a case of Prototheca wickerhamii cutaneous and systemic infections in an 85-year-old male with adrenal insufficiency. This organism was identified by morphological features and microbiological tests. The patient was successfully treated with ketoconazole.

Figure 1.

Multiple erythematous plaques are accompanied by papules, shallow ulcers, and crusts on his right upper limb and left lower limb.

Figure 2.

Gram stain of blood culture reveals spherical Gram-positive organisms of various sizes resembling yeast. Magnification, ×1,000.

Figure 3.

Milky white yeast-like colonies are observed on blood agar plate after incubation at 35°C for 3 days.

Figure 4.

Wet-mount preparation with lactophenol cotton blue discloses spherical sporangia containing multiple endospores with symmetrical arrangement. Magnification, ×1,000.