Thursday, July 31st, 2014

 

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Title:
An Unusual Presentation of Aspergillus Species in a Routine Cervicovaginal Pap Smear: A Case Report
Authors:  Smita Chandra, M.D., Dushyant Gaur, M.D., Meena Harsh, M.D., Jaya Chaturvedi, M.S., and Sanjeev Kishore, M.D.
 
Background: Finding fruiting bodies and hyphae of Aspergillus species in a routine cervicovaginal Pap smear is a rare occurrence. When encountered, it is important to distinguish between a true infection and contamination. The fruiting body also plays a very important role in distinguishing the various Aspergillus species. Case A 52-year-old woman underwent routine gynecologic and Pap smear examination. Her per-vaginal and per-speculum examinations were unremarkable. Pap smear showed atrophic changes with few acute inflammatory cells. However, a large number of hyphae and many fruiting bodies of Aspergillus species were observed in the smears. Close examination of the smear and clinical investigation indicated that the presence of Aspergillus species was due to contamination. Clinical follow-up with repeat Pap smear after 1 month was unremarkable.
Conclusion:
Fruiting bodies and hyphae of Aspergillus are rare in routine Pap smears. If seen, a differentiation between a true infection and contamination becomes mandatory. The fruiting bodies and hyphae provide an important clue to diagnosis of particular Aspergillus species and differentiating from other similar fungi. A contaminated smear overrules the toxic antifungal therapy and undue follow-up, whereas true infection requires careful study of immune status and prompt investigation. (Acta Cytol 2009;53: 229-231)
Keywords:  Aspergillus, contaminant, fruiting body, infection, Papanicolaou smear
   
   
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