A red, swollen and painful lesion on the right hand after local steroid injections

No evidence of immunosuppression was proven by tests for human immunodeficiency virus, hepatitis B virus, hepatitis C virus and diabetes.[1] Human protothecosis occurs more frequently in people with human immunodeficiency virus infection, diabetes mellitus, underlying malignancy, after chemotherapy, radiotherapy, renal transplantation, as well as in people who receive steroid treatment, locally or systemically.P. wickerhamii causes most cases of human protothecosis and the diagnostic histological feature of P. wickerhamii is round aggregation of endospores, giving a berry-like or flower-like appearance, which is best appreciated with special stains, such as Periodic acid-Schiff and Gomori methenamine silver stains.