Two cases of Cokeromyces recurvatus in liquid-based Papanicolaou tests and a review of the literature

Arch Pathol Lab Med. 2012 Dec;136(12):1593-6. doi: 10.5858/arpa.2011-0493-CR.

Abstract

We present 2 cases of Cokeromyces recurvatus in routine, liquid-based Papanicolaou tests (ThinPrep). Patient 1 is a healthy, asymptomatic, 26-year-old woman with no pertinent past medical history. Patient 2 is a healthy, asymptomatic, 47-year-old woman with no pertinent past medical history. The Papanicolaou tests from both patients showed many fungal-like elements as globose, yeastlike forms measuring 10 to 30 µm in diameter with multiple, narrowly attached apparent "daughter" buds. This morphology was consistent with Paracoccidioides brasiliensis. However, broad-range fungal polymerase chain reaction and deoxyribonucleic acid sequence analysis performed with GenBank Basic Local Alignment Search Tool showed an exact match for C recurvatus. Our cases highlight the importance of molecular techniques to prevent misdiagnosis of C recurvatus as P brasiliensis, based on morphology alone. There have been 8 previously published cases of C recurvatus infection in humans, 3 of which were reported in the female genital tract.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Cervix Uteri / microbiology*
  • Cervix Uteri / pathology
  • Databases, Nucleic Acid
  • Diagnosis, Differential
  • Female
  • Humans
  • Middle Aged
  • Molecular Typing
  • Mucorales / classification
  • Mucorales / cytology
  • Mucorales / isolation & purification*
  • Mucormycosis / diagnosis*
  • Mucormycosis / microbiology
  • Mucormycosis / pathology
  • Mycological Typing Techniques
  • Papanicolaou Test
  • Paracoccidioidomycosis / diagnosis
  • Reagent Kits, Diagnostic
  • Reproductive Tract Infections / diagnosis*
  • Reproductive Tract Infections / microbiology
  • Reproductive Tract Infections / pathology
  • Uterine Cervicitis / diagnosis*
  • Uterine Cervicitis / microbiology
  • Uterine Cervicitis / pathology
  • Vaginal Smears

Substances

  • Reagent Kits, Diagnostic