Direct microscopy of fluid aspirated from bursa or joint is helpful for early diagnosis of protothecal bursitis or protothecal arthritis

Abstract

Abstract: Objective To investigate the early diagnosis value and clinical application of direct microscopy of fluid aspirated from bursa or joint for diagnosing protothecal bursitis or protothecal arthritis. Methods In this paper, we reported a case of Prototheca wickerhamii infective interdigital arthritis admitted in our department in March 2022, and then we reviewed the literatures about protothecal bursitis or protothecal arthritison published in PubMed, CNKI and Wanfang Database from January 1, 1964 to May 31,2022. We analyzed the main etiological examination methods in different patients and the early diagnostic value of direct microscopy of fluid aspirated from bursa or joint. Results After selection, 18 articles (21 cases) conforming to the aim of the study were included. The main etiological examination methods included fungal culture and histologic examination, while fungal direct microscopy was often ignored.Among the 22 patients, only 2 patients underwent both direct microscopy and fungal culture, 18 patients underwent fungal culture without direct microscopy, and the remaining 2 patients were diagnosed by histologic examination without direct microscopy and fungal culture. Conclusions Direct microscopy of fluid aspirated from bursa or joint is helpful for early diagnosis of protothecal bursitis or protothecal arthritis.It deserves attention and promotion caused it lacks properly clinical application.

Key words: fluid aspirated from bursa, fluid aspirated from joint, direct microscopy, prototheca, infectious bursitis, infectious arthritis

CLC Number:

R 519.5

XIE Xinzhe, LU Sha, CAI Wenying, ZHANGJunmin, LI Jiahao, LIN Li, XI Liyan. Direct microscopy of fluid aspirated from bursa or joint is helpful for early diagnosis of protothecal bursitis or protothecal arthritis[J]. Chinese Journal of Mycology, 2023, 18(3): 216-220.

References

[1] TINDALL J P,FETTER B F.Infections caused by achloric algae (protothecosis)[J].Arch Dermatol,1971,104(5):490-500.
[2] NOSANCHUK J S,GREENBERG R D.Protothecosis of the olecranon bursa caused by achloric algae[J].Am J Clin Pathol,1973,59(4):567-573.
[3] GROCOTT R G,HUFFAKER A K,WHITE C B.Protothecal bursitis: A case from Panama[J].Lab Med,1979,10(2):89-96.
[4] Ahbel D E,Alexander A H,Kleine M L,et al.Protothecal olecranon bursitis. A case report and review of the literature[J].J Bone Joint Surg Am,1980, 62(5):835-836.
[5] KAPICA L.First case of human protothecosis in Canada:laboratory aspects[J].Mycopathologia,1981,73(1):43-48.
[6] HOLCOMB H S 3RD,BEHRENS F,WINN W C JR,et al.Prototheca wickerhamii-an alga infecting the hand[J].J Hand Surg Am,1981,6(6):595-599.
[7] VERNON S E,GOLDMAN L S.Protothecosis in the southeastern United States[J]. South Med J,1983,76(7):949-950.
[8] COCHRAN R K,PIERSON C L,SELL T L,et al.Protothecal olecranon bursitis: treatment with intrabursal amphotericin B[J].Rev Infect Dis,1986,8(6): 952-954.
[9] NARYSHKIN S,FRANK I,NACHAMKIN I.Prototheca zopfii isolated from a patient with olecranon bursitis[J].Diagn Microbiol Infect Dis,1987,6(2): 171-174.
[10] DE MONTCLOS M,CHATTÉ G,PERRIN-FAYOLLE M,et al.Olecranon bursitis due to Prototheca wickerhamii, an algal opportunistic pathogen[J].Eur J Clin Microbiol Infect Dis,1995,14(6):561-562.
[11] PASCUAL J S,BALOS L L,BAER A N.Disseminated Prototheca wickerhamii infection with arthritis and tenosynovitis[J].J Rheumatol,2004,31(9): 1861-1865.
[12] CURBELO A,PANKEY G A.A man presenting with nodules on hands and elbows[J]. Clin Infect Dis,2009,48(8):1114-1115,1160-1161.
[13] PEDNEKAR M,CHANDRA P A,MARGULIS Y,et al.Protothecal olecranon bursitis: an unusual algal infection[J].Am J Med Sci,2011,342(5):424.
[14] VAN DEN BOSSCHE D,DE HAAN R,VAN DER WERFF TEN BOSCH J,et al.Case report: Infrapatellar bursitis caused by Prototheca wickerhamii[J].Med Mycol Case Rep,2012,1(1):13-16.
[15] KNOX J,COLOE S V,PERERA C,et al.Prototheca wickerhamii olecranon bursitis successfully treated with adjunctive systemic itraconazole[J]. Pathology,2015,47(4):388-391.
[16] RAMÍREZ I,NIETO-RíOS J F,OCAMPO-KOHN C,et al.Protothecal bursitis after simultaneous kidney/liver transplantation:a case report and review[J]. Transpl Infect Dis,2016,18(2):266-274.
[17] 凌宝殿,胡蓉,黄俊云,等.威克海姆无绿藻致手指关节腱鞘炎1例并文献复习[J].临床检验杂志,2017,35(10):792-793.
[18] RAMANAN P,VIRK A,BOLAND J M,et al.Photo quiz: It's a concrete jungle out there[J].J Clin Microbiol,2018,56(8):e02417-16.
[19] RAMANAN P,VIRK A,BOLAND J M,et al.Answer to August 2018 photo quiz[J]. J Clin Microbiol,2018,56(8):e02418-16.
[20] YAGNIK K,BOSSÉ R,REPPUCCI J,et al.Case report: olecranon bursitis due to Prototheca wickerhamii in an immunocompromised patient[J].Am J Trop Med Hyg,2019,100(3):703-705.
[21] KATWILAT P,CHONGTRAKOOL P,MUANGSOMBOON S,et al.Prototheca wickerhamii prepatellar bursitis in an immunocompetent woman: A case report[J].J Mycol Med,2019,29(4):361-364.
[22] DAVIES R R,SPENCER H,WAKELIN P O.A case of human protothecosis[J]. Trans R Soc Trop Med Hyg,1964,58(5):448-451.
[23] TODD J R,KING J W,OBERLE A,et al.Protothecosis: report of a case with 20-year follow-up,and review of previously published cases[J]. Med Mycol, 2012,50(7):673-689.
[24] WANG F,FENG P,LIN Y,et al.Human cutaneous protothecosis:a case report and review of cases from China's mainland, Hong Kong, and Taiwan[J]. Mycopathologia,2018,183(5):821-828.