A protracted course of cutaneous protothecosis: Overcoming recurrence and treatment challenges.
Suxing Li, Yamei Lu, Dafu Yang et al.
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Case in brief
A 50-year-old male with a history of hypertension and gout presented with chronic, recurrent skin ulcers and abscesses due to Prototheca wickerhamii. His condition spanned nearly two years, involving multiple hospital admissions and a complex treatment regimen. Initial treatment was hindered by misdiagnosis and poor adherence, but a significant response was achieved through a combination of intravenous and intralesional amphotericin B.
Diagnostic / clinical pearl
Clinicians should consider protothecosis in the differential diagnosis of chronic, nonhealing ulcers, especially in immunocompromised patients.
Why it matters
This case emphasizes the necessity of antimicrobial susceptibility testing and the potential effectiveness of aggressive local injection therapy for refractory lesions.