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Algaemia is a secondary term that refers to the emerging condition in which
green algae The green algae (: green alga) are a group of chlorophyll-containing autotrophic eukaryotes consisting of the phylum Prasinodermophyta and its unnamed sister group that contains the Chlorophyta and Charophyta/ Streptophyta. The land plants ...
enter the bloodstream. Members of the genus '' Prototheca'' are the most common algae that leads to algaemia. ''Prototheca'' and ''
Chlorella ''Chlorella'' is a genus of about thirteen species of single- celled or colonial green algae of the division Chlorophyta. The cells are spherical in shape, about 2 to 10 μm in diameter, and are without flagella. Their chloroplasts contain t ...
'', which is extremely rare, are the only two known algae genera capable of inflicting disease on mammals, including humans, through invasion of host tissue. The majority of cases are observed in dairy cattle as a cause of bovine mastitis as well as other domesticated animals. Cases of algaemia have been observed in dogs and cats as well. Few cases have been observed in humans. Human cases of protothecosis are examined on a case-by-case basis due to the particularity of each case. Protothecosis infection is classified based on the symptoms: (i) cutaneous lesions, (ii) olecranon bursitis, and (iii) disseminated or systemic type infections.


Symptoms and signs

Protothecosis can affect anyone but is most commonly seen with more severe symptoms in those who have preexisting conditions. Individuals with a weak immune system have been shown to experience the worst symptoms. Many symptoms are not specific to this infection and can be hard to differentiate. ''Prototheca'' is not included as a typical infection that is screened for and is usually not identified without examination by microscope.
Polymerase chain reaction The polymerase chain reaction (PCR) is a method widely used to make millions to billions of copies of a specific DNA sample rapidly, allowing scientists to amplify a very small sample of DNA (or a part of it) sufficiently to enable detailed st ...
tests have shown to assists in the identification of ''Prototheca.'' Symptoms include but are not limited to: numbness in the extremities,
olecranon bursitis Olecranon bursitis is a condition characterized by swelling, redness, and pain at the tip of the elbow. If the underlying cause is due to an infection, fever may be present. The condition is relatively common and is one of the most frequent ty ...
or general inflammation, cutaneous infections in the hair, skin or fingernails, skin lesions, difficulty breathing, respiratory failure, multiple organ failure, and can result in death if not treated in the early stages of infection.


Causes

The algal cells are commonly found in the soil and water of many regions. ''Prototheca,'' especially '' P. wickerhamii and P. zopfii,'' can colonize the skin, fingernails, respiratory and digestive tracts. ''Prototheca'' algae cells can enter the bloodstream through open wounds, mucous membrane pathways, or the ingestion or inhalation of the cells. Individuals who are immunocompromised begin to see more concerning symptoms as the cells build up within the bloodstream.


Diagnosis


Treatments

Treatments for human protothecosis can range from pharmaceutical to surgical efforts. Anti-fungal medications such as
ketoconazole Ketoconazole, sold under the brand name Nizoral, among others, is an antiandrogen, antifungal drug, antifungal, and antiglucocorticoid medication used to treat a number of fungal infections. Applied to the skin it is used for fungal skin inf ...
,
itraconazole Itraconazole, sometimes abbreviated ITZ, is an antifungal medication used to treat a number of fungal infections. This includes aspergillosis, blastomycosis, coccidioidomycosis, histoplasmosis, and paracoccidioidomycosis. It may be given ...
, and amphotericin B are commonly given drugs for treatment.
Amphotericin B Amphotericin B is an antifungal medication used for serious fungal infections and leishmaniasis. The fungal infections it is used to treat include mucormycosis, aspergillosis, blastomycosis, candidiasis, coccidioidomycosis, and cryptococ ...
has proven to be the most effective but failure to treat or cure is not uncommon. Surgery is an option in some cases but is only when the infection remains localized in an area that can be excised.


History

''Prototheca'' is a genus of algae first identified by Wilhelm Krüger in 1894. Krüger first classified ''Prototheca'' as fungi. It was later reclassified as algae. It is believed that this genus of algae began with
photosynthetic Photosynthesis ( ) is a Biological system, system of biological processes by which Photoautotrophism, photosynthetic organisms, such as most plants, algae, and cyanobacteria, convert light energy, typically from sunlight, into the chemical ener ...
ability but over time transitioned to a parasitic form. Unlike most algae, prototheca cells lack
chlorophyll Chlorophyll is any of several related green pigments found in cyanobacteria and in the chloroplasts of algae and plants. Its name is derived from the Greek words (, "pale green") and (, "leaf"). Chlorophyll allows plants to absorb energy ...
and instead rely on a host for nutrients. Two groups within ''Prototheca'' have been identified: those typically associated with cattle (''P. ciferrii'' and ''P. bovis),'' and those considered human-associated (''P. wickerhamii, P. zopfii,'' and ''P. miyajii''). ''P. wickerhamii'' and ''P. zopfii'' are the predominant algae associated with algaemia. ''Prototheca'' can exist in a variety of environments but have been found frequently in warm and humid regions. This specific algae is more prevalent in the southern and southeastern portions of the United States as well as regions of northeastern Australia, southern portions of Europe, and Japan. The algal cells have been identified in samples from sewage, fresh and saltwater, animal feces, and some foods.


References

{{Infectious blood tests Abnormal clinical and laboratory findings for blood