Academic Journal
A protracted course of cutaneous protothecosis: Overcoming recurrence and treatment challenges.
| Τίτλος: | A protracted course of cutaneous protothecosis: Overcoming recurrence and treatment challenges. |
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| Συγγραφείς: | Li S; Department of Laboratory Medicine, Yuexi Hospital, The Sixth Affiliated Hospital of Sun Yat-sen University / Xinyi People's Hospital, Xinyi, Guangdong, China., Lu Y; Department of Laboratory Medicine, Taizhou Blood Center, Taizhou, China., Yang D; Medical Affairs Department, Yuexi Hospital, The Sixth Affiliated Hospital of Sun Yat-sen University / Xinyi People's Hospital, Xinyi, Guangdong, China., Yang J; Department of Pharmacy, Yuexi Hospital, The Sixth Affiliated Hospital of Sun Yat-sen University / Xinyi People's Hospital, Xinyi, Guangdong, China., Li R; Department of Endocrinology, Yuexi Hospital, The Sixth Affiliated Hospital of Sun Yat-sen University / Xinyi People's Hospital, Xinyi, Guangdong, China., Li C; Department of Laboratory Medicine, Yuexi Hospital, The Sixth Affiliated Hospital of Sun Yat-sen University / Xinyi People's Hospital, Xinyi, Guangdong, China., Huang S; Department of Laboratory Medicine, Yuexi Hospital, The Sixth Affiliated Hospital of Sun Yat-sen University / Xinyi People's Hospital, Xinyi, Guangdong, China., Li L; Department of Laboratory Medicine, Yuexi Hospital, The Sixth Affiliated Hospital of Sun Yat-sen University / Xinyi People's Hospital, Xinyi, Guangdong, China., Guo J; Department of Laboratory Medicine, Shanghai East Hospital, School of Life Sciences and Technology, Tongji University, Shanghai, China. Electronic address: guojian1110@126.com. |
| Πηγή: | International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2026 Sep; Vol. 170, pp. 108970. Date of Electronic Publication: 2026 Jul 09. |
| Τύπος έκδοσης: | Case Reports; Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: Canada NLM ID: 9610933 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-3511 (Electronic) Linking ISSN: 12019712 NLM ISO Abbreviation: Int J Infect Dis Subsets: MEDLINE |
| Imprint Name(s): | Publication: Hamilton, ON : Elsevier Original Publication: Hamilton, ON : Decker, c1996- |
| Ιατρικοί όροι (MeSH): | Prototheca*/isolation & purification , Prototheca*/drug effects , Prototheca*/genetics , Amphotericin B*/therapeutic use , Amphotericin B*/administration & dosage , Infections*/drug therapy , Infections*/diagnosis , Infections*/microbiology, Skin Ulcer/drug therapy ; Skin Ulcer/microbiology ; Anti-Bacterial Agents/therapeutic use ; Humans ; Male ; Middle Aged ; Recurrence ; Immunocompromised Host ; Treatment Outcome ; Skin Diseases, Infectious |
| Περίληψη: | This report describes a case of chronic, recurrent cutaneous and soft tissue infection caused by Prototheca wickerhamii in a 50-year-old male, presenting with recurrent skin ulcers and abscess formation. The patient had a history of grade 3 hypertension and gout, along with a record of irregular glucocorticoid use. The clinical course was protracted, spanning nearly two years and involving three hospital admissions with a complex treatment trajectory. The isolate was identified as P. wickerhamii through mass spectrometry and CYTB sequencing. In vitro susceptibility testing demonstrated that amphotericin B (AMB) exhibited potent activity against the P. wickerhamii isolate. While the initial treatment phase was complicated by early missed diagnosis and poor patient adherence, leading to recurrent relapses, a significant therapeutic response was ultimately achieved by employing a comprehensive strategy combining intravenous administration with intralesional injection of AMB for refractory lesions. This case highlights the importance of broadening the differential diagnosis for chronic, nonhealing ulcers in immunocompromised hosts to include protothecosis. Furthermore, it underscores that management should be guided by antimicrobial susceptibility testing; for refractory localized lesions, aggressive local injection therapy is a viable option, and strict adherence management is crucial to minimize the risk of recurrence. (Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
| Contributed Indexing: | Keywords: Amphotericin B; Cutaneous infection; Prototheca wickerhamii; Recurrent infection |
| Substance Nomenclature: | 7XU7A7DROE (Amphotericin B) 0 (Anti-Bacterial Agents) |
| SCR Disease Name: | protothecosis |
| Entry Date(s): | Date Created: 20260709 Date Completed: 20260805 Latest Revision: 20260805 |
| Update Code: | 20260805 |
| DOI: | 10.1016/j.ijid.2026.108970 |
| PMID: | 42425361 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1878-3511 |
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| DOI: | 10.1016/j.ijid.2026.108970 |