Paracoccidioides brasiliensis in a postpartum pap smear - A case report

BACKGROUND: There ape several reported cases that describe female genital t ract infections with opportunistic fungi, such as Blastomyces dermatitidis, Coccidioides immitis, Aspergillus flavus, Cryptococcus neoformans and Muco r. We describe a case of paracoccidiodomycosis limited to the uterine cervi x. To the best of our knowledge, no such case has been described before in the English-language literature. CASE: A 27-year-old, healthy female, gravida 3, para 2, abortion 1, present ed for a routine gynecologic examination at six weeks' postpartum. Her past medical history was unremarkable. A routine cervical/endocervical smear re vealed the presence of multiple fungal forms at different stages of develop ment with a characteristic "pilot's wheel" appearance consistent with Parac occidioides brasiliensis. Detailed medical examination of the patient did M ot reveal the presence of the primary infection in any other system. Cultur es of the endometrium revealed no growth of the fungal organisms. The patie nt was asymptomatic, and therefore no therapy was initiated. Repeat Papanic olaou smears were negative for organisms. CONCLUSION: Paracoccidioidomycosis can present as a limited form, involving the cervix only. Identification and recognition of the infection are impor tant in cytopathology.