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Med Mycol. 2012 Oct;50(7):673-89. doi: 10.3109/13693786.2012.677862. Epub 2012 May 9.

Protothecosis: report of a case with 20-year follow-up, and review of previously published cases.

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Section of Infectious Diseases, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130 - 3932, USA.


We present a Prototheca wickerhamii wound infection case that failed treatment with ketoconazole but was cured with amphotericin-B plus tetracycline. The patient was immunocompetent but had had local steroid injections. We reviewed another 159 cases from the literature. Prototheca has infected many areas of the human body, but most often skin, olecranon bursa, or wounds. Prior treatment with steroids and immune deficiencies are contributing factors. Itraconazole and fluconazole are reasonable initial treatments for patients with mild infections. For serious infections, or for infections that have failed azole treatment, amphotericin-B is the treatment of choice.

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