Photo Quiz: Globose Yeast-Like Forms With Multiple Peripheral Buds in Urine and Cervical Cytology.
Adil Menon, Rachel Koch, Caroline Abramovich
✦ AI-curated · Sources linked
Case in brief
A 26-year-old immunocompetent woman with a history of low-grade papillary urothelial carcinoma presented with upper abdominal pain. Urine cytology revealed globose, yeast-like forms resembling Paracoccidioides brasiliensis. Identical organisms were later found in a cervical Pap test. The findings were attributed to Cokeromyces recurvatus, highlighting the importance of accurate identification to prevent misdiagnosis and unnecessary treatment.
What made this case unusual
This case uniquely demonstrates the simultaneous detection of Cokeromyces recurvatus in both urine and cervical cytology, indicating multisite genitourinary colonization.
Diagnostic / clinical pearl
Clinicians should be cautious when interpreting yeast-like forms in cytology, as morphology alone may lead to misdiagnosis of fungal infections.
Why it matters
This case emphasizes the need for culture or molecular confirmation when encountering atypical fungal morphology to avoid unnecessary antifungal therapy.