Cutaneous protothecosis in a patient receiving immunosuppressive therapy.

A 30-year-old recipient of a renal transplant, who was receiving immunosuppressive therapy, developed cutaneous abscesses from which an organism of the genus Prototheca was cultured. The patient died of Klebsiella septicemia. At the time of death, pure cultures of Prototheca and Candida organisms were grown from separate skin lesions. Prototheca is a genus of achloric algae. Cultural, microscopical, and staining characteristics separate these organisms from the yeast and fungi. Cutaneous protothecosis was first described in 1964 by Davies et al in an otherwise healthy African rice farmer. Since that time, nine other cases have been reported. However, only a single case has been described in a patient receiving immunosuppressive drugs, a woman with carcinoma of the breast who was receiving chemotherapy with multiple agents.