Unusual microbial organisms seen in two cervical smears

Brimo, Fadi; Ouad, Lydiai; Brodeur, Catherine; Charbonneau, C T Michele; Auger, Manon

doi:10.1002/dc.21114

Cited by 7 publications

(20 citation statements)

References 11 publications

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Section: Discussionmentioning

confidence: 96%

“…Certain reports describe cervical smears where the authors conclude that the results could be due to contamination, as the other five slides exhibited the same hyphae (5,6). Additional case reports exhibited a smear test result with a description of a fruiting body in a patient (6,7). Deb and Srivastava (3) and Gupta et al (5) reported concomitant Aspergillus in patients with high-grade intraepithelial lesions, which could be explained by their immunocompromised state (3,5,9).…”

Section: Discussionmentioning

confidence: 96%

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Aspergillus in liquid-based cervicovaginal cytology in a postmenopausal patient: A case report

et al. 2017

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Abstract.Aspergillus is an opportunistic fungus present in humid environments, whose natural environment is in soil, hay and compost. It is a frequent contaminant in the clinical laboratory. Because of this, the fungus is often inhaled, affecting those with an underlying pulmonary disease or immune deficiency. Fungal genitourinary tract infections are relatively common. A rare Aspergillus spp cervical infection diagnosed via liquid-based cytology is presented in the current study. The 57-year-old woman attended her annual check-up without any relevant medical history. The result of a gynecological examination by Papanicolaou smear was normal and routine liquid-based cytology was performed. The specimen exhibited fungal organisms characterized by septate hyphae branching at acute angles, most consistent with the Aspergillus species. Subsequent cytology demonstrated the same results. Antifungal treatment was initiated and a second post-treatment smear only exhibited atrophy. The cytomorphological features of Aspergillus spp. are discussed in the current study and a brief review of the few reported cases of a primary cervical infection in the literature is provided. In addition, the liquid-based cytology was established as a tool to diagnose the rare Aspergillus infection. IntroductionThe most relevant of the Aspergillus species are fumigatus, flavus and niger. These grow in the natural environment, and in tissues and cultures in the form of hyphae that produce conidia upon exposure to air. Conidia consist of a conidiophore with a terminal vesicle in which one or two layers of phialides are developed. The prevalence of genitourinary tract infections has been reported to be as high as 52% in the female population, with the most common cause being Candida albicans in 28% (1). With the exception of Candida, other fungi are rarely observed in Papanicolaou (Pap) smears or biopsies, with isolated reports of opportunistic infections, such as Blastomyces dermatitidis, Coccidioides immitis, Cryptococcus neoformans and mucor being published (2,3). To the best of our knowledge, this is one of few Aspergillus infection cases reported regarding infection by Aspergillus as diagnosed via liquid-based gynecologic cytology, including a clinical and cytological follow-up. Case reportThe patient was a 57-year-old Mexican woman who had been through the menopause five years previously and she had no relevant medical history. During an annual medical checkup in July 2015, the patient went to the gynecology service at the Hospital Universitario 'Dr José Eleuterio González' (Monterrey, Mexico). She presented without any signs, symptoms or concerns. Furthermore, previous checkups revealed no anomalies. However, the physical examination revealed an atrophic state in the vagina and cervix.Previous patient authorization, a routine liquid-based cervical cytology was performed and demonstrated atrophy with a predominance of parabasal cells and scarce endocervical cells. Of note, multiple fungal structures with uniform and homogeneous forms, and...

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

Aspergillus in liquid-based cervicovaginal cytology in a postmenopausal patient: A case report

et al. 2017

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“…Awareness about such exogenous structures helps in their correct categorization and discrimination from true infection. To date, there are only seven cases of Penicillium, three cases of Aspergillus in non‐intra‐uterine device users and a single case of Cladosporium reported individually on cervical cytology in the literature. Our nine cases are the first largest case series of these unusual fungal bodies, which very well exemplifies their coexistence and the need to remain vigilant for such contaminants.…”

Section: Discussionmentioning

confidence: 99%

“…Fungal organisms like Candida are commonly seen in conventional cervical smears. Unusual and rare fungi‐like Aspergillus spp, Penicillium spp, and Cladosporium spp have been individually reported in literature in cervical smears . We report nine cases of Penicillium, Aspergillus, and Cladosporium contaminating conventional cervical smears from healthy women.…”

Section: Introductionmentioning

confidence: 90%

Unusual fungal bodies in conventional cervical smears: Report of nine cases

Jain

Singh

Singhla

et al. 2014

Diagnostic Cytopathology

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Candida spp have often been reported in cervical cytology, other fungal organisms are very rare in modern literature. We report nine cases of conventional cervical smears showing Penicillium, Aspergillus, and Cladosporium spp in healthy immunocompetent females. Penicillium spp seen in four out of nine smears, Cladosporium spp alone in three out of nine smears, and Cladosporium spp along with Aspergillus spp in two out of nine smears. A detail of these nine cases is presented with discussion on importance of these structures when observed in conventional cervical smears. Awareness of such contaminants is important to differentiate from true infection for relevant therapeutic implications. A systematic step-wise approach to such structures is also suggested.

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“…When encountered it is important to distinguish between a true infection and contamination. [25][26][27][28] A contaminated smear overrules the toxic antifungal therapy and undue follow-up, whereas true infection requires careful study of immune status and prompt therapy. 6 Aspergillus is an environmental fungus transmitted by airborne conidia.…”

Section: Aspergillus As Contaminant In Cervicovaginal Papanicolaou Smmentioning

confidence: 99%

Aspergillus and Cervicovaginal Papanicolaou Smear: A Review

Kaur¹

2017

ICPJL

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Background: Aspergillus is a ubiquitous fungus known to cause aspergillosis in immunocompromised patients. The involvement of female genital tract by this fungus is rarely described. Reports of finding Aspergillus in cervicovaginal smears have appeared.Method: A comprehensive literature search was conducted from the websites of Pubmed Central, the US National Library of Medicine's digital archive of life sciences literature (http://www.pubmedcentral.nih.gov), and Google Scholar. And All articles displayed using the search words "Aspergillus and cervicovaginal smear" were included in this review. Books that published relevant articles in this field were also considered. Result:The Aspergillus is identified in smears by conidiophores and characteristic hyphae against a background of squamous cells and inflammatory cells. It should be confirmed and characterized by culture. Conclusion:Contamination should be ruled out in all the cases of Aspergillus in cervicovaginal Papanicolaou smear. Treatment should be done to prevent serious consequences in the patients if pelvic surgery is done and in a potential situation when patient develops an immunocompromised state in future.

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Unusual microbial organisms seen in two cervical smears

Cited by 7 publications

References 11 publications

Aspergillus in liquid-based cervicovaginal cytology in a postmenopausal patient: A case report

Aspergillus in liquid-based cervicovaginal cytology in a postmenopausal patient: A case report

Unusual fungal bodies in conventional cervical smears: Report of nine cases

Aspergillus and Cervicovaginal Papanicolaou Smear: A Review

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