Cutaneous infection caused by Prototheca wickerhamii identified using VITEK MS following pretreatment with a mold extraction protocol: a case report
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Prototheca wickerhamii is an achlorophyllic algae that rarely acts as an opportunisticpathogen in humans. We report the case of a 66-year-old female patient with a history ofdiabetes mellitus who presented with a pus-like discharge from face, facial redness, andswelling. The patient was admitted to the emergency room with worsening facial pain. Gramstaining from pus-like discharge revealed yeast like features; however, an isolated colonyon a blood agar plate was not identified using VITEK 2 (Biomerieux) or matrix-assistedlaser desorption/ionization time-of flight mass spectrometry (MALDI-TOF) using VITEK MS(Biomerieux). Lactophenol cotton blue staining of the colony revealed characteristic sporangiaand endospore features. After performing the protein extraction procedure for filamentousfungi (mold) isolates using ethanol and formic acid, MALDI-TOF MS identified the colony asPrototheca wickerhamii, with 99.9% confidence. This case indicates that Prototheca spp. require specialized sample preparation steps, such as the ethanol/formic acid extractionprocedure, for identification using MALDI-TOF MS
Abstract
Prototheca wickerhamii is an achlorophyllic algae that rarely acts as an opportunisticpathogen in humans. We report the case of a 66-year-old female patient with a history ofdiabetes mellitus who presented with a pus-like discharge from face, facial redness, andswelling. The patient was admitted to the emergency room with worsening facial pain. Gramstaining from pus-like discharge revealed yeast like features; however, an isolated colonyon a blood agar plate was not identified using VITEK 2 (Biomerieux) or matrix-assistedlaser desorption/ionization time-of flight mass spectrometry (MALDI-TOF) using VITEK MS(Biomerieux). Lactophenol cotton blue staining of the colony revealed characteristic sporangiaand endospore features. After performing the protein extraction procedure for filamentousfungi (mold) isolates using ethanol and formic acid, MALDI-TOF MS identified the colony asPrototheca wickerhamii, with 99.9% confidence. This case indicates that Prototheca spp. require specialized sample preparation steps, such as the ethanol/formic acid extractionprocedure, for identification using MALDI-TOF MS
참고문헌 (22)
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