title: Fungal spores and fruiting bodies in cervicovaginal smears: Contaminant or infection?
abstract: BACKGROUND
  Contaminants from various sources are curious findings in cervicovaginal smears and pose diagnostic challenges especially when they need to be distinguished from pathogens. Candidiasis is the most frequently encountered fungal infection but fungal contaminants are relatively common. Detection of fruiting bodies and spores of Aspergillus species is uncommon and may represent either a true infection or contamination. This study was undertaken to evaluate the presence of fungal spores, hyphae, and fruiting bodies in routine cervical smears and distinguish a true infection from contamination.
  
  
  METHODS
  Conventional cervicovaginal smears collected from women were incidentally found to have fungal fruiting bodies and spores. All smears received in the Cytology Department during that one month were reviewed for the presence of these elements.
  
  
  RESULTS
  Five out of the 120 smears, received from the outpatient department over a period of three consecutive days, showed evidence of fungal organisms. The patients were 28-59 years of age. While four patients were asymptomatic, only one patient complained of minimal vaginal discharge. All were immunocompetent. Cervicovaginal smears were prepared as part of routine screening. Fungal fruiting bodies, branching hyphae and numerous spores were seen in otherwise normal smears. Culture of scrapings from the surface of the wooden spatulas grew Aspergillus niger.
  
  
  CONCLUSIONS
  Contamination of Pap smears by fungus must be distinguished from true infection, the latter being supported by positive clinical findings and the presence of significant inflammation in the smears. Literature review was done to see the range of contaminants detected in Pap smears. Diagn. Cytopathol. 2017;45:191-194. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Departments of Pathology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors.forename: Hema
authors.initials: H
authors.lastname: Kini
authors.affiliation: Departments of Pathology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors.forename: Jyoti R
authors.initials: JR
authors.lastname: Kini
authors.affiliation: Departments of Microbiology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors.forename: Ethel
authors.initials: E
authors.lastname: Suman
authors.affiliation: Departments of Pathology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
authors.forename: Sharada
authors.initials: S
authors.lastname: Rai
mesh_terms: D000328:Adult; D001234:Aspergillus niger / Q000302:isolation & purification*; D005260:Female; D048690:Fruiting Bodies, Fungal / Q000302:isolation & purification*; D006801:Humans; D008875:Middle Aged; D013172:Spores, Fungal / Q000302:isolation & purification*; D014621:Vagina / Q000382:microbiology*; D014626:Vaginal Smears
keywords: PAP conventional; cervical cytology; contaminants; fruiting bodies; fungal spores; hyphae