Cokeromyces recurvatus: A rare fungus in the Pap test of an asymptomatic woman

Multiple Consecutive Cervicovaginal Cytology Specimens Confirm Persistent Colonization by Cokeromyces recurvatus: Case Report and Literature Review

“…This patient was successfully treated with antifungal therapy, intravaginal terconazole [5]. One previous patient, a 37-year-old asymptomatic female, was described to have C. recurvatus organisms present in cervicovaginal cytology specimens prepared 1 year apart, highlighting that C. recurvatus may be capable of long-term colonization of the female genital tract [2].…”

“…Each year in the United States, approximately 50 million cervicovaginal cytology cancer screening tests (Pap tests) are performed. A review of the literature confirms only seven reported cases of C. recurvatus in cervicovaginal cytology specimens; each of these being described in the last 25 years [2][3][4][5][6][7]. In all of the previously reported cases of C. recurvatus from cervicovaginal cytology specimens, no patients have been shown to have invasive fungal disease in the gynecologic tract; however, one pregnant patient with clinical cervicitis attributed to coinfection with C. recurvatus and Candida albicans was successfully treated with antifungal therapy [5].…”

“…Cervicovaginal cytology specimens harboring the yeastlike form of C. recurvatus organisms have been reported in the literature in 7 cases, and 4 of those cases had cultures confirming the fungal organism [2,5,6,7]. When identified outside of the gynecologic tract, C. recurvatus has been known to cause hemorrhagic cystitis in a 72-year-old, diverticulitis in a 9-year-old, and fatal pneumonia in an immunocompromised 27-year-old [8][9][10].…”