Cutaneous Protothecosis in a Patient with AIDS and a Severe Functional Neutrophil Defect: Successful Therapy with Amphotericin B

Prototheca species are achlorophyllic algae that remain rare pathogens. Fewer than 100 cases of protothecosis have been reported and in most cases the patients (primarily immunocompromised) presented with skin disease or olecranon bursiris. Despite the AIDS epidemic, and with it the rise of a multitude of exotic opportunistic infections, protothecosis remains rare in patients with AIDS; there has been only one report of cutaneous protothecosis and two describing noncutaneous infections in AIDS patients. We present what we believe is the second case of cutaneous protothecosis in an AIDS patient, and we discuss treatment options and examine neutrophil function.