Loa loa presenting in a ThinPrep^® Pap test^™: Case report and review of parasites in cervicovaginal cytology specimens

Abstract

Parasites other than Trichomonas vaginalis may occasionally present in Pap tests obtained during gynecologic examination. We present a case of Loa loa found on a Pap test from an apparently healthy 19-yr-old woman who had immigrated to the US at the age of 15 from Cameroon. We discuss the cytologic features from this case and then briefly review Loa loa and the presence of parasites in Pap tests and other cervicovaginal specimens.

Association of Schistosoma haematobium and Human Papillomavirus in Cervical Cancer

“…[29][30][31] These findings emphasize the fact that one must be aware of rare parasites while screening routine Pap smears. [8][9][10] …”

“…They have the additional benefit of detecting multiple infections, such as parasitic, protozoan, fungal, bacterial and viral, in a single smear at no additional cost. 8,9 The patient had registered 5 years earlier for the family planning services at the family welfare clinic of this institute. During her first visit, she complained of vaginal discharge and pruritis vulvae; clinical examination revealed a copper device in situ with endocervicitis and uterine tenderness, for which she was treated with doxyclycline (100 mg twice a day for 7 days) and povidone iodine vaginal pessaries ( One year after insertion, the patient complained of vaginal discharge and pruritis vulvae; clinical examination revealed the IUD in situ with endocervicitis and uterine tenderness, for which she was treated with doxycycline (100 mg twice a day for 14 days) and tinidazole (500 mg twice a day for 5 days); her husband was given a 1-g,…”

“…Typical cytomorphologic diagnostic characteristics of Schistosoma are not frequent, and Pap smear screening for the detection of parasitic infections is well reported. [8][9][10] Retrospective analysis of yearly follow-ups with Pap smears for the past 13 years showed mild inflammatory changes associated with bacterial vaginosis ( Figure 1B) followed by negative normal smears ( Figure 1C), and then the smear revealed monilial infection ( Figure 1D), followed by an S haematobium egg ( Figure 1A) and followed by Actinomyces-like organisms ( Figure 1E), which are generally associated with Cu IUD users. 11 Later, the smears revealed HPV infection associated with atypical squamous cells of undetermined significance (ASCUS) ( Figure 1F).…”

Worm‐like artifacts in exfoliative cytology

“…4 The presence of such microorganisms in cytological smears is important, as this finding, although sometimes accidental, may have implications for prognosis and therapy. However, on numerous occasions, the presence of other structures, varied in nature but with similar morphological features, may give rise to confusion and/or incorrect interpretation.…”

Enterobius (Pinworm) ova in a liquid‐based gynecologic cytology specimen

“…In very rare instances, other parasites or their ova can also be seen. 1 One such parasite is Enterobius vermicularis.…”