Cutaneous Protothecosis with Meningitis Due to Prototheca wickerhamii in an Immunocompetent Teenager: Case Report and Literature Review

Yanfei Lu,1,2,* Xiaohui Zhang,1,2,* Fang Ni,1,2 Wenying Xia1,2 1Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, People’s Republic of China; 2National Key Clinical Department of Laboratory Medicine, Nanjing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wenying XiaDepartment of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Street No. 300, Guangzhou, 210029, People’s Republic of ChinaTel +8625-6830-6287Fax +8625- 8372-4440Email xiawenying21106891@163.comAbstract: Human protothecosis is a rare infection caused by Prototheca spp., which are environmental achloric algae ubiquitously existing in nature. Members of the genus of Prototheca usually cause localized infection that affects the skin or wounds. Systemic infection is extremely rare and tends to occur in immunocompromised patients. Here, we report a case of cutaneous protothecosis and meningitis due to Prototheca wickerhamii in an immunocompetent teenager who obtained full-body tattoos at the time of infection. To the best of our knowledge, this is the first description of P. wickerhamii isolated from both skin tissue and cerebrospinal fluid. The data contained in this report will increase our understanding of this pathogen and elucidate the most optimal treatment.Keywords: Prototheca wickerhamii, cutaneous protothecosis, meningitis, immunocompeten