{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T06:49:47Z","timestamp":1757314187389,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,6,23]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>\n                  <jats:italic>Prototheca wickerhamii<\/jats:italic> is a common, indolent alga that seldom causes central nervous system infections in humans. We report the first UK case of cerebral protothecosis in an immunocompetent 56-year-old woman who presented with a 5-month history of intermittent fatigue followed by a 2-week history of symptoms, including right arm and leg weakness, a loss of fine motor coordination, worsening gait, right facial tingling, diplopia and a metallic oral taste. MRI scans revealed a multifocal abnormality suggestive of high-grade glioma. Given the clinical presentation, absence of immunodeficiency and characteristic MRI features, a diagnosis of high-grade glioma was deemed most likely by the multidisciplinary team. Surgical biopsy provided material for histopathological and microbiological diagnosis. She underwent a 2-year course of antimicrobials with surveillance MRI scans. The patient made a good functional recovery but still retains mild neurological sequelae.<\/jats:p>","DOI":"10.1136\/bcr-2020-235362","type":"journal-article","created":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T12:40:12Z","timestamp":1611664812000},"page":"e235362","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Cerebral protothecosis mimicking high-grade glioma"],"prefix":"10.1136","volume":"14","author":[{"given":"James","family":"Samarasekara","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Queen's Hospital, Romford, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soumya","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King's College Hospital, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azzam","family":"Ismail","sequence":"additional","affiliation":[{"name":"Department of 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