Protothecosis B88.83

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Very rare chronic infection of the skin and subcutaneous fatty tissue by algae (Prototheca zopfii or P. wickerhamii). Occurs as a dermatitis type with papulo-macular, sometimes ulcerated lesions in immunocompromised patients or as a circumscribed infection type (infection of the bursa olecrani) in immunocompetent patients.

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Potassium iodide for 6-8 weeks: Initially 0.1-0.5 g 3-4 times/day, later increase to 0.5-1.0 g 3-4 times/day, total dose 3-6 g/day. Total dose in children 1.5-2.0 g/day.


Exclusion of hyperthyroidism before starting therapy! Risk of iodine-induced thyrotoxic crisis! Combination with Amphotericin B 0.1 mg/kg bw/day i.v., increase up to 1 mg/kg bw/day is possible. Alternative: liposomal Amphotericin B (e.g. AmBisome) initial 1 mg/day/kg bw i.v.; if necessary, increase stepwise to 3 mg/day/kg bw i.v. until complete healing.

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  1. Chao SC et al (2002) Cutaneous protothecosis: report of five cases. Br J Dermatol 146: 688-693
  2. Cho BK et al (2002) Cutaneous protothecosis. Int J Dermatol 41: 304-306
  3. Goldstein D et al (1986) Herpetiform Protothecosis. Int J Derm 25: 54-55
  4. Kantrow SM et al (2003) Protothecosis. Dermatol Clin 21: 249-255
  5. Mc Anally et al (1985) Cutaneous protothecosis presenting as recurrent chromomycosis. Arch Dermatol 121: 1066-1068
  6. Piyophirapong S et al (2002) Cutaneous protothecosis in an AIDS patient. Br J Dermatol 146: 713-715
  7. Wirth FA et al (1999) Disseminated cutaneous protothecosis in an immunocompromised host: a case report and literature review. Cutis 63: 185-188


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Last updated on: 29.10.2020