Visceral protothecosis mimicking sclerosing cholangitis in an immunocompetent host: Successful antifungal therapy

J. C. Chan, Lennox J Jeffers, E. W. Gould, Duane Hutson, Octavio V. Martinez, K. R. Reddy, F. Hassan, Eugene R Schiff

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

A healthy 39-year-old man who had clinical findings consistent with sclerosing cholangitis was found to have systemic protothecosis at surgery. Severe granulomatous inflammation and palpable nodules were found in the gallbladder, on the surface of the liver, and in the duodenum. Prototheca wickerhamii was detected in biopsied specimens and stool; the titer of indirect fluorescent antibody to this organism was 1:2,000. The patient recovered after a short course of treatment with amphotericin B and 3 months of oral therapy with ketoconazole. He had no other concurrent illness and had no abnormality in his immune system. This is the second reported human case of systemic protothecosis. An elevated IgG level, an elevated erythrocyte sedimentation rate, eosinophilia, and abnormal levels of enzymes in the liver were found in both cases. Protothecosis should be considered in the differential diagnosis of hepatic and biliary inflammatory diseases of uncertain etiology.

Original languageEnglish
Pages (from-to)802-807
Number of pages6
JournalReviews of Infectious Diseases
Volume12
Issue number5
StatePublished - Jan 1 1990

Fingerprint

Sclerosing Cholangitis
Liver
Prototheca
Ketoconazole
Blood Sedimentation
Eosinophilia
Amphotericin B
Gallbladder
Duodenum
Immune System
Differential Diagnosis
Therapeutics
Immunoglobulin G
Inflammation
Antibodies
Enzymes

ASJC Scopus subject areas

  • Microbiology (medical)

Cite this

Visceral protothecosis mimicking sclerosing cholangitis in an immunocompetent host : Successful antifungal therapy. / Chan, J. C.; Jeffers, Lennox J; Gould, E. W.; Hutson, Duane; Martinez, Octavio V.; Reddy, K. R.; Hassan, F.; Schiff, Eugene R.

In: Reviews of Infectious Diseases, Vol. 12, No. 5, 01.01.1990, p. 802-807.

Research output: Contribution to journalArticle

Chan, J. C. ; Jeffers, Lennox J ; Gould, E. W. ; Hutson, Duane ; Martinez, Octavio V. ; Reddy, K. R. ; Hassan, F. ; Schiff, Eugene R. / Visceral protothecosis mimicking sclerosing cholangitis in an immunocompetent host : Successful antifungal therapy. In: Reviews of Infectious Diseases. 1990 ; Vol. 12, No. 5. pp. 802-807.
@article{0c7cc9a12c3d4d52bc679ef5cc786215,
title = "Visceral protothecosis mimicking sclerosing cholangitis in an immunocompetent host: Successful antifungal therapy",
abstract = "A healthy 39-year-old man who had clinical findings consistent with sclerosing cholangitis was found to have systemic protothecosis at surgery. Severe granulomatous inflammation and palpable nodules were found in the gallbladder, on the surface of the liver, and in the duodenum. Prototheca wickerhamii was detected in biopsied specimens and stool; the titer of indirect fluorescent antibody to this organism was 1:2,000. The patient recovered after a short course of treatment with amphotericin B and 3 months of oral therapy with ketoconazole. He had no other concurrent illness and had no abnormality in his immune system. This is the second reported human case of systemic protothecosis. An elevated IgG level, an elevated erythrocyte sedimentation rate, eosinophilia, and abnormal levels of enzymes in the liver were found in both cases. Protothecosis should be considered in the differential diagnosis of hepatic and biliary inflammatory diseases of uncertain etiology.",
author = "Chan, {J. C.} and Jeffers, {Lennox J} and Gould, {E. W.} and Duane Hutson and Martinez, {Octavio V.} and Reddy, {K. R.} and F. Hassan and Schiff, {Eugene R}",
year = "1990",
month = "1",
day = "1",
language = "English",
volume = "12",
pages = "802--807",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "5",

}

TY - JOUR

T1 - Visceral protothecosis mimicking sclerosing cholangitis in an immunocompetent host

T2 - Successful antifungal therapy

AU - Chan, J. C.

AU - Jeffers, Lennox J

AU - Gould, E. W.

AU - Hutson, Duane

AU - Martinez, Octavio V.

AU - Reddy, K. R.

AU - Hassan, F.

AU - Schiff, Eugene R

PY - 1990/1/1

Y1 - 1990/1/1

N2 - A healthy 39-year-old man who had clinical findings consistent with sclerosing cholangitis was found to have systemic protothecosis at surgery. Severe granulomatous inflammation and palpable nodules were found in the gallbladder, on the surface of the liver, and in the duodenum. Prototheca wickerhamii was detected in biopsied specimens and stool; the titer of indirect fluorescent antibody to this organism was 1:2,000. The patient recovered after a short course of treatment with amphotericin B and 3 months of oral therapy with ketoconazole. He had no other concurrent illness and had no abnormality in his immune system. This is the second reported human case of systemic protothecosis. An elevated IgG level, an elevated erythrocyte sedimentation rate, eosinophilia, and abnormal levels of enzymes in the liver were found in both cases. Protothecosis should be considered in the differential diagnosis of hepatic and biliary inflammatory diseases of uncertain etiology.

AB - A healthy 39-year-old man who had clinical findings consistent with sclerosing cholangitis was found to have systemic protothecosis at surgery. Severe granulomatous inflammation and palpable nodules were found in the gallbladder, on the surface of the liver, and in the duodenum. Prototheca wickerhamii was detected in biopsied specimens and stool; the titer of indirect fluorescent antibody to this organism was 1:2,000. The patient recovered after a short course of treatment with amphotericin B and 3 months of oral therapy with ketoconazole. He had no other concurrent illness and had no abnormality in his immune system. This is the second reported human case of systemic protothecosis. An elevated IgG level, an elevated erythrocyte sedimentation rate, eosinophilia, and abnormal levels of enzymes in the liver were found in both cases. Protothecosis should be considered in the differential diagnosis of hepatic and biliary inflammatory diseases of uncertain etiology.

UR - http://www.scopus.com/inward/record.url?scp=0025089079&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025089079&partnerID=8YFLogxK

M3 - Article

C2 - 2237120

AN - SCOPUS:0025089079

VL - 12

SP - 802

EP - 807

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 5

ER -