Definitive diagnosis and speciation can be achieved only by carbohydrate assimilation studies from culture. The organism grows on Sabouraud dextrose agar, blood agar, Tween 80 agar, eosin methylene blue agar, or MacConkey agar. The organism grows poorly at room temperature. Creamy white colonies are usually visible within 3 days. Treatment options for cutaneous protothecosis are limited, and the disease is especially difficult to eradicate in immunocompromised persons.
Lesions tend to recur and eventually spread to other sites.
At the present time, there is no standard treatment regimen for protothecosis. In localized lesions, surgical excision has been successful. Since the population of individuals infected with HIV continues to increase, it is possible that additional cases of this rare infection may be reported. A case of human protothecosis. First human case of possible protothecosis in Spain.