title: Cokeromyces recurvatus in a cervical papanicolaou test: A case report of a rare fungus with a brief review of the literature.
abstract: Here we report a rare case of Cokeromyces recurvatus in a Pap test in an asymptomatic pregnant patient. Each liquid-based Pap slide contained multiple rounded yeast-like forms measuring 10-30 µm including some profiles with peripheral small buds. The background had neither epithelial abnormality nor any significant inflammation. A positive silver stain aided in confirming a fungal organism. Rare fungi were considered including Paracoccidioides brasiliensis due to the 'mariner's wheel' morphology of forms with peripheral budding; however, the final report morphologically favored C. recurvatus which was subsequently confirmed by culture. This is the sixth report of C. recurvatus isolated at a gynecologic site. While C. recurvatus has been reported to cause invasive disease in immunocompromised patients at deep sites, in the gynecologic tract it has so far been reported as a non-pathogenic colonizer. Awareness of this organism and use of either culture or molecular diagnostics are important in avoiding misdiagnosis.
authors.affiliation: Department of Pathology and Laboratory Medicine, Women and Infants Hospital of Rhode Island, Providence, Rhode Island.|Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Cherie
authors.initials: C
authors.lastname: Paquette
authors.affiliation: Department of Pathology and Laboratory Medicine, Women and Infants Hospital of Rhode Island, Providence, Rhode Island.|Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Shahrzad E
authors.initials: SE
authors.lastname: Slater
authors.affiliation: Warren Alpert Medical School of Brown University, Providence, Rhode Island.|Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Providence, Rhode Island.
authors.forename: Megan D
authors.initials: MD
authors.lastname: McMahon
authors.affiliation: Department of Pathology and Laboratory Medicine, Women and Infants Hospital of Rhode Island, Providence, Rhode Island.|Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: M Ruhul
authors.initials: MR
authors.lastname: Quddus
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D009090:Mucorales / Q000302:isolation & purification*; D009091:Mucormycosis / Q000382:microbiology* / Q000473:pathology; D065006:Papanicolaou Test; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology* / Q000473:pathology; D014626:Vaginal Smears
keywords: Cokeromyces recurvatus; Pap test; Paracoccidiodes brasiliensis