title: Two cases of Cokeromyces recurvatus in liquid-based Papanicolaou tests and a review of the literature.
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.
authors.affiliation: Cleveland Clinic, Pathology and Laboratory Medicine Institute, Cleveland, Ohio, USA.
authors.forename: Shelley I
authors.initials: SI
authors.lastname: Odronic
authors.forename: Thomas
authors.initials: T
authors.lastname: Scheidemantel
authors.forename: Marion J
authors.initials: MJ
authors.lastname: Tuohy
authors.forename: Deborah
authors.initials: D
authors.lastname: Chute
authors.forename: Gary W
authors.initials: GW
authors.lastname: Procop
authors.forename: Christine N
authors.initials: CN
authors.lastname: Booth
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000382:microbiology* / Q000473:pathology; D030561:Databases, Nucleic Acid; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D058889:Molecular Typing; D009090:Mucorales / Q000145:classification / Q000166:cytology / Q000302:isolation & purification*; D009091:Mucormycosis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D016533:Mycological Typing Techniques; D065006:Papanicolaou Test; D010229:Paracoccidioidomycosis / Q000175:diagnosis; D011933:Reagent Kits, Diagnostic; D060737:Reproductive Tract Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D002575:Uterine Cervicitis / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D014626:Vaginal Smears
chemical_list: D011933:Reagent Kits, Diagnostic