"Fruiting body" of Aspergillus species in a routine cervico-vaginal smear (Pap test)
"Fruiting body" of Aspergillus species in a routine cervico-vaginal smear (Pap test)
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DOI：
10.1002/dc.20267
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发表时间：
2005-10-01
影响因子：
1.3
通讯作者：
Houser, PM
中科院分区：
文献类型：
--
作者：
Hoda, RS;Colello, C;Houser, PM
女性生殖道真菌感染常见，以念珠菌为主。是宫颈阴道(巴氏涂片)检查中最常见的类型。在巴氏试验中，很少有其他真菌类型的报告，如副球孢子虫和烟曲霉。这是一张来自一例罕见的曲霉菌的图像。出现在ThinPrep(TP)宫颈阴道(Pap)测试中。一位42岁的健康女性，无明显病史，接受了常规的TP巴氏试验。她的妇科检查并不引人注目。TP的细胞学检查显示，在许多良性鳞状细胞和少数腺体细胞的背景下，曲霉菌只有一个“子实体”(图4)。C-1)。没有发现菌丝形态，也没有发现任何炎症。对残留的TP样本进行真菌特殊染色(Gomori亚甲胺-银染)，结果为阴性。临床随访结果平淡无奇。由于患者没有症状，没有进行微生物培养，也没有进行抗真菌治疗。曲霉菌是一种常见的环境真菌，在其他健康的人中会引起过敏(啤酒者的肺)，在免疫抑制的人中会引起严重的呼吸道感染和真菌血症。烟曲霉是人类最常见的病原体。曲霉属(Aspergilla spp.)是通过空气传播的分生孢子，而肺是进入的主要门户。该真菌的特征是菌丝相隔，宽3-6 mm，分枝呈锐角(458)。真菌形成分生孢子头或“子实体”，在空洞(曲菌球)或通风良好的区域产生孢子。这些微小的孢子很容易在空气中传播。子实体在特定曲霉种的鉴定和曲霉的形态与其模拟物的区分中是重要的。分生孢子梗的长度和宽度、小泡的大小和轮廓、孢子丝的排列以及分生孢子链的颜色、大小和长度可以进行物种鉴定。曲霉属(Aspergilla spp.)在形态上不能与其模拟物如接合菌属和假丝酵母属区分开来。除非伴随着子实体。曲霉属(Aspergilla spp.)在巴氏试验中很少见。它可能代表长期接受抗生素治疗的患者的症状性感染，或那些患有单纯性小阴唇皮肤曲霉病(严重免疫功能受损的罕见并发症)或污染的患者。子实体具有独特的形态，对曲霉菌的鉴定具有重要意义。并将其与其仿制品区分开来。
Fungal infection of female genital tract is common, with Candida spp. being the most frequent type seen on a cervico-vaginal (Pap smear) test. There are rare reports of other fungal types, such as Paracoccidioides and Aspergillus fumigatus, in a Pap test. This is an image from an unusual case of Aspergillus spp. presenting in a ThinPrep (TP) cervico-vaginal (Pap) test. A 42-yr-old healthy woman, with no significant medical history, underwent a routine TP Pap test. Her gynecologic examination was unremarkable. Cytologic examination of the TP revealed a single ‘‘fruiting body’’of Aspergillus in a background of numerous benign squamous and a few glandular cells (Fig. C-1). Niether hyphal forms nor any inflammation was identified. Special staining for fungi (Gomori methenamine-silver stain), performed on the residual TP sample was negative. Clinical follow-up was uneventful. Microbiologic culture was not performed and no antifungal therapy was instituted, as the patient was asymptomatic. Aspergillus is a common environmental fungus that causes allergies (brewer’s lung) in otherwise healthy individuals and severe respiratory infections and fungemia in immunosuppressed individuals. Aspergillus fumigatus is the most frequent human pathogen. Aspergillus spp. is transmitted by airborne conidia, and the lung is the major portal of entry. The fungus is characterized by septate hyphae, 3–6 mm in width, with acute-angle (458) branching. The fungi form conidial head or ‘‘fruiting bodies’’that produce spores in cavities (aspergilloma) or in areas that are well aerated. These tiny spores can easily be airborne. The fruiting body is important in the identification of a particular Aspergillus species and in morphologic differentiation of Aspergillus from its mimics. The length and width of conidiophores, size and contour of the vesicle, arrangement of phillides, and the color, size, and length of chains of conidia allow species identification. Aspergillus spp. cannot be morphologically distinguished from its mimics such as Zygomycetes and Candida spp. unless it is accompanied by the fruiting bodies. Aspergillus spp. in a Pap test is rare. It may represent a symptomatic infection in patients on prolonged antibiotic treatment, or those with isolated cutaneous aspergillosis of the labia minora (a rare complication of severe immunocompromised states) or a contamination. Fruiting body has a unique morphology and is important in identifying various Aspergillus spp. and distinguishing it from its mimics.