Paracoccidioides brasiliensis in a liquid-based Papanicolaou test from a pregnant woman:: Report of a case

With the exception of Candida species, fungal organisms are rarely encountered in the Papanicolaou test and, when encountered, usually represent contaminants rather then infections. We present the case of a healthy 29-year-old pregnant female, gravida 1, para 0, who presented for her first prenatal visit at 12-week gestation and had many large fungal-like elements with a distinct budding pattern of multiple narrow-based buds resembling a "ship's-wheel" identified in her routine liquid-based Papanicolaou test. Based on its characteristic appearance in the Papanicolaou test and the hematoxylin and eosin, periodic acid Schiff and Gomori's methenamine silver stains performed on the cell block made from the residual sample, the fungus was diagnosed as "consistent with Paracoccidioides." This is the second reported case of Paracoccidioides presenting in a Papanicolaou test and shows that this organism may rarely involve the uterine cervix in the absence of clinical systemic disease.