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Nojo H, Ishijima SA, Morikawa M, Ito T, Kano R. In vitro susceptibility testing of phytochemicals from essential oils against Prototheca species. J Vet Med Sci 2024; 86:847-849. [PMID: 38925982 DOI: 10.1292/jvms.24-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024] Open
Abstract
Phytochemicals isolated from essential oils are effective alternatives for inhibiting microbial pathogens. Bovine protothecal mastitis is the cause of a reduction in milk production and the secretion of thin, watery milk with white flakes. In the present study, we performed in vitro susceptibility testing of the phytochemicals carvacrol, citral, and thymol in Prototheca strains isolated from cases of protothecosis in small animals and cow feces. The susceptibility of the algae to carvacrol, citral, and thymol was assessed using the modified CLSI M27-A3 broth microdilution method. The ranges of the minimum inhibitory concentrations (MIC%) of the phytochemicals in all isolates were 0.03% to 0.125% for carvacrol, 0.03% to 0.25% for citral, and 0.06% to 0.25% for thymol. Based on these results, carvacrol, citral, and thymol appear effective against Prototheca species at the tested concentrations, and may thus be useful for environmental disinfection in barns.
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Affiliation(s)
- Honoka Nojo
- Teikyo University Institute of Medical Mycology (TIMM), Tokyo, Japan
| | - Sanae A Ishijima
- Teikyo University Institute of Medical Mycology (TIMM), Tokyo, Japan
| | - Mako Morikawa
- Veterinary Hospital Aichi P.F.A.M.A.A., Aichi, Japan
| | - Takaaki Ito
- Veterinary Hospital Aichi P.F.A.M.A.A., Aichi, Japan
| | - Rui Kano
- Teikyo University Institute of Medical Mycology (TIMM), Tokyo, Japan
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2
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Cullen GD, Yetmar ZA, Fida M, Abu Saleh OM. Prototheca Infection: A Descriptive Study. Open Forum Infect Dis 2023; 10:ofad294. [PMID: 37389225 PMCID: PMC10300632 DOI: 10.1093/ofid/ofad294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 06/02/2023] [Indexed: 07/01/2023] Open
Abstract
Prototheca is a microalgae known to cause infections in humans, with protothecosis most commonly presenting as olecranon bursitis or localized soft tissue infection. Disseminated disease can be seen in immunocompromised patients. In this retrospective single-institution case series, we describe our experience with 7 patients with Prototheca infections.
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Affiliation(s)
- Grace D Cullen
- Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Zachary A Yetmar
- Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Madiha Fida
- Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Omar M Abu Saleh
- Correspondence: Omar M. Abu Saleh, MBBS, Mayo Clinic, 200 First St S.W., Rochester, MN 55905 ()
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3
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Proskurnicka A, Żupnik K, Bakuła Z, Iskra M, Rösler U, Jagielski T. Drug Susceptibility Profiling of Prototheca Species Isolated from Cases of Human Protothecosis. Antimicrob Agents Chemother 2023; 67:e0162722. [PMID: 36943065 PMCID: PMC10112244 DOI: 10.1128/aac.01627-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Prototheca are unicellular, achlorophyllous, yeast-like microalgae that occur in a wide range of natural habitats. At least five species have been implicated as the causative agents of opportunistic infections of men. Human protothecosis typically manifests as cutaneous, articular, or systemic disease. Treatment is largely empirical with poorly predictable and often unsuccessful outcomes. This is largely due to the frequently observed resistance of Prototheca species to conventional antimicrobial agents. This work is the first to perform drug susceptibility profiling exclusively on isolates from human cases of protothecosis. A total of 23 such isolates were tested against amphotericin B and 9 azoles, including efinaconazole and luliconazole, whose activities against Prototheca have never been studied before. Efinaconazole was the most active, with median minimum inhibitory concentration (MIC) and minimum algicidal concentration (MAC) values of 0.031 mg/L and 0.063 mg/L, respectively. Fluconazole and luliconazole had the lowest activity, with median MIC and MAC values of 128 mg/L. To conclude, amphotericin B and most of the azoles showed in vitro activity, with an algicidal rather than algistatic effect, against Prototheca. Still, the activity of individual drugs differed significantly between the species and even between strains of the same species. These differences can be attributed to a species-specific potential for acquiring drug resistance, which, in turn, might be linked to the treatment history of the patient from whom the strain was recovered. The results of this study underscore the potential clinical utility of efinaconazole as a promising therapeutic agent for the treatment of human protothecosis.
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Affiliation(s)
- Angelika Proskurnicka
- Department of Medical Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, Warsaw, Poland
| | - Kinga Żupnik
- Department of Medical Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, Warsaw, Poland
| | - Zofia Bakuła
- Department of Medical Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, Warsaw, Poland
| | - Mateusz Iskra
- Department of Medical Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, Warsaw, Poland
| | - Uwe Rösler
- Institute for Animal Hygiene and Environmental Health, Freie Universität Berlin, Berlin, Germany
| | - Tomasz Jagielski
- Department of Medical Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, Warsaw, Poland
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Yamashita M, Ikeda M, Kato I, Ohama Y, Ando M, Ikemura M, Jubishi D, Kanno Y, Okamoto K, Umeyama T, Nakamura S, Miyazaki Y, Okugawa S, Moriya K. Protothecosis in the mucosa of the pharynx mimicking pharyngeal cancer in an immunocompetent individual: a case report. Ann Clin Microbiol Antimicrob 2022; 21:5. [PMID: 35164794 PMCID: PMC8845227 DOI: 10.1186/s12941-022-00495-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 01/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background Protothecosis is a rare infection in humans and animals caused by the achlorophyllic algae Prototheca species. More than half of the protothecosis cases are cutaneous infections, and most cases are observed in immunocompromised individuals. Case presentation We report a case of Prototheca wickerhamii infection in the mucosa of the pharynx in a 53-year-old immunocompetent woman with an incidentally found mass lesion at the left tongue base. Histopathological findings of the mass lesion suggested cryptococcosis, but P. wickerhamii was identified from the oropharynx scrape culture based on DNA sequencing. After surgical resection, fosfluconazole treatment was initiated, and subsequently, treatment was switched to topical amphotericin B. The residual mass lesion did not deteriorate during the 4-month antifungal treatment and 1-year observational period. Conclusions Prototheca species can be easily misdiagnosed as yeasts because of their morphological and pathological similarities. Prototheca, in addition to Cryptococcus should be considered if slow-growing, large Gram-positive organisms are encountered. Lactophenol cotton blue staining of the colony helps distinguish these organisms. Further study is needed to determine the appropriate treatment according to the infection focus.
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Affiliation(s)
- Marie Yamashita
- Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mahoko Ikeda
- Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. .,Department of Infection Control and Prevention, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Ito Kato
- Department of Clinical Laboratory, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
| | - Yuki Ohama
- Department of Infection Control and Prevention, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mizuo Ando
- Department of Otorhinolaryngology and Head and Neck Surgery, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Masako Ikemura
- Department of Pathology, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Daisuke Jubishi
- Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yoshiaki Kanno
- Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Koh Okamoto
- Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Takashi Umeyama
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, 1-23-1, Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
| | - Shigeki Nakamura
- Department of Microbiology, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan
| | - Yoshitsugu Miyazaki
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, 1-23-1, Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
| | - Shu Okugawa
- Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kyoji Moriya
- Department of Infectious Diseases, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Infection Control and Prevention, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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5
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Guo J, Jian J, Wang L, Xiong L, Lin H, Zhou Z, Sonnenschein EC, Wu W. Genome Sequences of Two Strains of Prototheca wickerhamii Provide Insight Into the Protothecosis Evolution. Front Cell Infect Microbiol 2022; 12:797017. [PMID: 35186789 PMCID: PMC8847788 DOI: 10.3389/fcimb.2022.797017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
The Prototheca alga is the only chlorophyte known to be involved in a series of clinically relevant opportunistic infections in humans and animals, namely, protothecosis. Most pathogenic cases in humans are caused by Prototheca wickerhamii. In order to investigate the evolution of Prototheca and the genetic basis for its pathogenicity, the genomes of two P. wickerhamii strains S1 and S931 were sequenced using Nanopore long-read and Illumina short-read technologies. The mitochondrial, plastid, and nuclear genomes were assembled and annotated including a transcriptomic data set. The assembled nuclear genome size was 17.57 Mb with 19 contigs and 17.45 Mb with 26 contigs for strains S1 and S931, respectively. The number of predicted protein-coding genes was approximately 5,700, and more than 96% of the genes could be annotated with a gene function. A total of 2,798 gene families were shared between the five currently available Prototheca genomes. According to the phylogenetic analysis, the genus of Prototheca was classified in the same clade with A. protothecoides and diverged from Chlorella ~500 million years ago (Mya). A total of 134 expanded genes were enriched in several pathways, mostly in metabolic pathways, followed by biosynthesis of secondary metabolites and RNA transport. Comparative analysis demonstrated more than 96% consistency between the two herein sequenced strains. At present, due to the lack of sufficient understanding of the Prototheca biology and pathogenicity, the diagnosis rate of protothecosis is much lower than the actual infection rate. This study provides an in-depth insight into the genome sequences of two strains of P. wickerhamii isolated from the clinic to contribute to the basic understanding of this alga and explore future prevention and treatment strategies.
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Affiliation(s)
- Jian Guo
- Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jianbo Jian
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Lyngby, Denmark
| | - Lili Wang
- Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Lijuan Xiong
- Department of Laboratory Medicine, Guizhou University The Second Affiliated Hospital of Traditional Chinese Medicine, Guizhou, China
| | - Huiping Lin
- Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ziyi Zhou
- Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Eva C. Sonnenschein
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Lyngby, Denmark
- *Correspondence: Wenjuan Wu, ; Eva C. Sonnenschein,
| | - Wenjuan Wu
- Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
- *Correspondence: Wenjuan Wu, ; Eva C. Sonnenschein,
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6
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Kano R, Kazuo Satoh, Yaguchi T, Masuda M, Makimura K, de Hoog GS. Phenotypic Characteristics of <i>Prototheca</i> Species Occurring in Humans and Animals. Med Mycol J 2022; 63:17-20. [DOI: 10.3314/mmj.21-00018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Rui Kano
- Department of Veterinary Dermatology, Nihon University College of Bioresource Sciences
| | - Kazuo Satoh
- General Medical Education and Research Center, Teikyo University
| | | | - Michiaki Masuda
- Department of Microbiology, Dokkyo Medical University School of Medicine
| | | | - G. Sybren de Hoog
- Center of Expertise in Mycology, Radboud University Medical Center/Canisius Wilhelmina Hospital
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7
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Álvarez-Pérez S, Anega B, Díaz-de-Tuesta JA, González-Martín JV, Riesgo-Martínez M, García ME, Blanco JL. Susceptibility testing of Prototheca bovis isolates from cases of bovine mastitis using the CLSI reference broth microdilution method and the Sensititre YeastOne colorimetric panel. Med Mycol 2021; 59:1257-1261. [PMID: 34643716 DOI: 10.1093/mmy/myab063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/04/2021] [Accepted: 10/11/2021] [Indexed: 11/14/2022] Open
Abstract
A total of 62 Prototheca bovis isolates from cases of bovine mastitis were tested for susceptibility to different antifungal compounds by the Clinical and Laboratory Standards Institute (CLSI) reference microdilution method and a commercial colorimetric microdilution panel (Sensititre YeastOne). All isolates displayed low susceptibility to echinocandins (MICs > 8 μg/ml for anidulafungin, caspofungin, and micafungin), flucytosine (MIC > 64 μg/ml), and the azoles enilconazole and fluconazole (MICs > 4 and > 64 μg/ml, respectively). Moreover, 45.2%, 32.3%, and 1.6% of isolates had MICs > 4 μg/ml for ketoconazole, terbinafine, and voriconazole, respectively, when tested by the CLSI method. In contrast, all isolates were more susceptible to the polyene compounds amphotericin B and nystatin, and itraconazole, posaconazole, and ravuconazole (MICs ≤ 2 μg/ml, in all cases). Comparison of the results obtained in the CLSI and Sensititre methods showed excellent essential agreement (EA) for azoles (98.4% for itraconazole and posaconazole, and 100% for voriconazole) and moderate EA for amphotericin B (72.6%), when MICs were read after 24 h and 48 h of incubation, respectively. In contrast, much lower EA values were obtained in some cases when the MICs for both techniques were determined after 48 h of incubation (e.g., 9.7% for amphotericin B and 69.4% for posaconazole). Therefore, the CLSI broth microdilution method and the Sensititre YeastOne panel can be used indistinctly for susceptibility testing of P. bovis isolates against azoles but not against amphotericin B until further optimization of the test conditions. LAY SUMMARY The antifungal susceptibility of Prototheca bovis isolates was analyzed. All tested isolates displayed low susceptibility to echinocandins, flucytosine, and some azoles. Excellent agreement of the results of two different test methods was obtained for azoles, but not for the polyene amphotericin B.
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Affiliation(s)
- Sergio Álvarez-Pérez
- Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain
| | - Blanca Anega
- Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain
| | - Juan A Díaz-de-Tuesta
- Regional Laboratory for Animal Health, Community of Madrid, Colmenar Viejo, Madrid, Spain
| | - Juan V González-Martín
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain.,VISAVET Health Surveillance Centre, Complutense University of Madrid, Madrid, Spain
| | | | - Marta E García
- Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain
| | - José L Blanco
- Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, Madrid, Spain
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Watanabe T, Ishikawa T, Sato H, Hirose N, Nonaka L, Matsumura K, Masubuchi A, Nishimura K, Masuda M. Characterization of Prototheca CYP51/ERG11 as a possible target for therapeutic drugs. Med Mycol 2021; 59:855-863. [PMID: 33838030 DOI: 10.1093/mmy/myab012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/17/2021] [Indexed: 11/13/2022] Open
Abstract
Prototheca spp. are achlorophyllous algae, ubiquitous in nature. An increasing number of human and animal cases of Prototheca infection (protothecosis) are reported, and antifungal azoles, which inhibit sterol 14α-demethylase (CYP51/ERG11) involved in ergosterol biosynthesis, have empirically been used for the treatment of protothecosis. Although Prototheca, like fungi, has ergosterol in the cell membrane, efficacy of the antifungal azoles in the treatment of protothecosis is controversial. For investigating the interaction of azole drugs with Prototheca CYP51/ERG11, the CYP51/ERG11 genomic genes of four strains of P. wickerhamii and one strain each of P. cutis and P. miyajii were isolated and characterized in this study. Compared with the CYP51/ERG11 gene of chlorophyllous Auxenochlorella Protothecoides, it is possible that ProtothecaCYP51/ERG11 gene, whose exon-intron structure appeared to be species-specific, lost introns associated with the loss of photosynthetic activity. Analysis of the deduced amino acid sequences revealed that Prototheca CYP51/ERG11 and fungal CYP51/ERG11 are phylogenetically distant from each other although their overall structures are similar. Our basic in silico studies predicted that antifungal azoles could bind to the catalytic pocket of Prototheca CYP51/ERG11. It was also suggested that amino acid residues away from the catalytic pocket might affect the drug susceptibility. The results of this study may provide useful insights into the phylogenetic taxonomy of Prototheca spp. in relationship to the CYP51/ERG11 structure and development of novel therapeutic drugs for the treatment of protothecosis. LAY SUMMARY Cases of infection by microalgae of Prototheca species are increasing. However, effective treatment has not been established yet. In this study, gene and structure of Prototheca's CYP51/ERG11, an enzyme which might serve as a target for therapeutic drugs, were characterized for the first time.
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Affiliation(s)
- Takahisa Watanabe
- Department of Microbiology, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan.,Hirara Clinic, Okinawa 906-0012, Japan
| | - Tomohiro Ishikawa
- Department of Microbiology, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan
| | - Hirotaka Sato
- Department of Microbiology, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan
| | - Noriyuki Hirose
- Department of Microbiology, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan.,BD Japan, Co., Ltd., Tokyo 107-0052, Japan
| | - Lisa Nonaka
- Department of Microbiology, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan.,Department of Nutritional Science, Faculty of Human Life Science, Shokei University, Kumamoto 862-8678, Japan
| | - Kaori Matsumura
- Department of Microbiology, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan
| | - Akira Masubuchi
- Department of Microbiology, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan
| | - Kazuko Nishimura
- Department of Microbiology, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan.,First Laboratories, Co. Ltd., Kanagawa 211-0013, Japan
| | - Michiaki Masuda
- Department of Microbiology, Dokkyo Medical University School of Medicine, Tochigi 321-0293, Japan
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Masuda M, Jagielski T, Danesi P, Falcaro C, Bertola M, Krockenberger M, Malik R, Kano R. Protothecosis in Dogs and Cats-New Research Directions. Mycopathologia 2020; 186:143-152. [PMID: 33206310 DOI: 10.1007/s11046-020-00508-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 11/02/2020] [Indexed: 11/25/2022]
Abstract
Protothecosis refers to disease of humans and animals caused by infection with fungus-like, colourless microalgae of the genus Prototheca. Although protothecosis remains an uncommon infection, increasing numbers of human and animal cases are being diagnosed worldwide. This review summarises major new findings in basic science (sequencing analyses of sterol 14α-demethylase (CYP51/ERG11) genes and organelle genomes of Prototheca wickerhamii) to elucidate taxonomic features of this pathogen. Furthermore, this review updates and summarises the clinical features, diagnosis and treatment of protothecosis in dogs and cats. This content of this review is based on information presented at the medical phycology symposium held in the 20th Congress of the International Society for Human and Animal Mycology ( https://www.isham.org/ ).
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Affiliation(s)
- Michiaki Masuda
- Department of Microbiology, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Tomasz Jagielski
- Department of Medical Microbiology, Institute of Microbiology, University of Warsaw, Warsaw, Poland
| | - Patrizia Danesi
- Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, PD, Italy
| | - Christian Falcaro
- Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, PD, Italy
| | - Michela Bertola
- Istituto Zooprofilattico Sperimentale Delle Venezie, Legnaro, PD, Italy
| | - Mark Krockenberger
- Veterinary Pathology Diagnostic Services (VPDS), Sydney School of Veterinary Science, The University of Sydney, B14, Sydney, NSW, Australia
| | - Richard Malik
- Centre for Veterinary Education, The University of Sydney, B22, Sydney, NSW, 2006, Australia
| | - Rui Kano
- Department of Veterinary Dermatology, Nihon University School of Veterinary Medicine, 1866, Kameino, Fujisawa, Kanagawa, 252-0880, Japan.
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