TY - JOUR T1 - Cerebral protothecosis mimicking high-grade glioma JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2020-235362 VL - 14 IS - 1 SP - e235362 AU - James Samarasekara AU - Soumya Mukherjee AU - Azzam Ismail AU - Robert Corns Y1 - 2021/01/01 UR - http://casereports.bmj.com/content/14/1/e235362.abstract N2 - Prototheca wickerhamii is a common, indolent alga that seldom causes central nervous system infections in humans. We report the first UK case of cerebral protothecosis in an immunocompetent 56-year-old woman who presented with a 5-month history of intermittent fatigue followed by a 2-week history of symptoms, including right arm and leg weakness, a loss of fine motor coordination, worsening gait, right facial tingling, diplopia and a metallic oral taste. MRI scans revealed a multifocal abnormality suggestive of high-grade glioma. Given the clinical presentation, absence of immunodeficiency and characteristic MRI features, a diagnosis of high-grade glioma was deemed most likely by the multidisciplinary team. Surgical biopsy provided material for histopathological and microbiological diagnosis. She underwent a 2-year course of antimicrobials with surveillance MRI scans. The patient made a good functional recovery but still retains mild neurological sequelae. ER -