{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T18:21:17Z","timestamp":1773166877324,"version":"3.50.1"},"reference-count":10,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3,6]]},"abstract":"<jats:p>Human protothecosis is a rare algal infection caused by <jats:italic>Prototheca<\/jats:italic>; it is a ubiquitous achlorophyllic alga, which rarely causes human disease. Currently, the pathogenesis remains unclear and no treatment options have been elucidated. We present a case of olecranon bursitis caused by <jats:italic>Prototheca wickerhamii<\/jats:italic> in an immunocompromised patient. A 45-year-old man presented with left elbow pain after scraping his elbow on a tree. He reported significant pain and swelling of the elbow after injury, which resolved without intervention. He was diagnosed with HIV\/AIDS infection and started on antiretroviral therapy. Afterward, he experienced recurrent elbow swelling and pain; an incision and drainage was performed and cultures demonstrated <jats:italic>P. wickerhamii<\/jats:italic>. Unsuccessful treatment with oral voriconazole led to an attempt at therapy with parental amphotericin and oral doxycycline; however the patient left against medical advice. He presented to our facility and both parental amphotericin and doxycycline were initiated with planned outpatient bursectomy. He clinically improved on that regimen but left against medical advice before completing his recommended course of IV amphotericin and oral doxycycline. Patients diagnosed with disseminated protothecosis can have a mortality rate upward of 67%. Given the rarity of this pathogen, no official treatment guidelines exist and there are few studies analyzing the antimicrobial susceptibility of <jats:italic>Prototheca<\/jats:italic>. Management is challenging because of slow-growing nature of the algae, paucity of research studies, and limited susceptibility of this pathogen. This case adds to the limited body of literature by demonstrating the clinical presentation of protothecosis and highlighting the pathology and current treatment options.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0818","type":"journal-article","created":{"date-parts":[[2018,12,27]],"date-time":"2018-12-27T07:00:49Z","timestamp":1545894049000},"page":"703-705","source":"Crossref","is-referenced-by-count":4,"title":["Case Report: Olecranon Bursitis due to Prototheca wickerhamii in an Immunocompromised Patient"],"prefix":"10.4269","volume":"100","author":[{"given":"Kruti","family":"Yagnik","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Florida College of Medicine, Gainesville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rapha\u00ebl","family":"Boss\u00e9","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Florida College of Medicine, Gainesville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Reppucci","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Florida College of Medicine, Gainesville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Butts","sequence":"additional","affiliation":[{"name":"University of Florida College of Medicine, Gainesville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shehla","family":"Islam","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Florida College of Medicine, Gainesville, Florida;"},{"name":"Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida, Gainesville, Florida;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony P.","family":"Cannella","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Florida College of Medicine, Gainesville, Florida;"},{"name":"Division of Infectious Diseases and Global Medicine, Department of Medicine, University of Florida, Gainesville, Florida;"},{"name":"Department of Molecular Genetics and Microbiology, University of Florida College of Medicine, Gainesville, Florida;"},{"name":"Emerging Pathogens Institute, University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Clin Microbiol Rev","first-page":"230","article-title":"Human protothecosis","volume":"20","author":"Lass-Fl\u00f6rl","year":"2007"},{"key":"b2","series-title":"Bull Soc Pathol Exot","first-page":"484","article-title":"Human protothecosis and environment","volume":"86","author":"Huerre","year":"1993"},{"key":"b3","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"561","article-title":"Olecranon bursitis due to Prototheca wickerhamii, an algal opportunistic pathogen","volume":"14","author":"De Montclos","year":"1995"},{"key":"b4","series-title":"Int J Hyg Environ Health","first-page":"297","article-title":"Protothecosis in human medicine","volume":"204","author":"Thiele","year":"2002"},{"key":"b5","series-title":"Clin Dermatol","first-page":"432","article-title":"Protothecosis","volume":"30","author":"Mayorga","year":"2012"},{"key":"b6","series-title":"Med Mycol","first-page":"673","article-title":"Protothecosis: report of a case with 20-year follow-up, and review of previously published cases","volume":"50","author":"Todd","year":"2012"},{"key":"b7","series-title":"Diagn Microbiol Infect Dis","first-page":"186","article-title":"Prototheca wickerhamii as a cause of neuroinfection in a child with congenital hydrocephalus. First case of human protothecosis in Poland","volume":"74","author":"\u017bak","year":"2012"},{"key":"b8","series-title":"Clin Microbiol Infect","first-page":"786","article-title":"Protothecosis in patients with cancer: case series and literature review","volume":"9","author":"Torres","year":"2003"},{"key":"b9","series-title":"Clin Infect Dis","first-page":"1265","article-title":"Cutaneous protothecosis in a patient with AIDS and a severe functional neutrophil defect: successful therapy with amphotericin B","volume":"25","author":"Carey","year":"1997"},{"key":"b10","series-title":"Med Mycol Case Rep","first-page":"21","article-title":"Successful treatment of cutaneous protothecosis with liposomal amphotericin and oral itraconazole","volume":"12","author":"McMullan","year":"2016"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/100\/3\/article-p703.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/100\/3\/article-p703.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/100\/3\/article-p703.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T11:38:30Z","timestamp":1722425910000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/100\/3\/article-p703.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,6]]},"references-count":10,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.18-0818","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,6]]}}}