J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 15, Number 1, January 2023, pages 31-37

Rapid Cytological Diagnosis With Evaluation of Pre- and Post-Therapeutic Fungal Morphological Characteristics in Mucormycosis

Figures

Figure 1. Pre-treatment sample showing viable branching hyphae with sporangia and few degenerated columnar cells (PAP, × 40). PAP: Papanicolaou.

Figure 2. Pre-treatment sample showing viable hyphae with sporangia, absence of inflammatory cells in vicinity and mature superficial squamous cells (H&E, × 40). H&E: hematoxylin and eosin.

Figure 3. Post-treatment sample showing a degenerated hyphae being attacked by neutrophils (H&E, × 40). H&E: hematoxylin and eosin.

Figure 4. Post-treatment sample showing entangled degenerated hyphae being attacked by inflammatory cells (H&E, × 40). H&E: hematoxylin and eosin.

Figure 5. Post-treatment sample showing degenerated hyphal fragment along with a multi-nucleated giant cell (H&E, × 40). H&E: hematoxylin and eosin.

Tables

**Table 1.** Comparison of Crush Smear and KOH Mount Diagnosis With Histopathology and Culture
Diagnosis	Crush smear	KOH mount	Histopathology	Culture
^aThree cases reported as suspicious on crush smear were considered as positive for patient management and statistical purpose.
Positive	29 + 3^a	30	40	36
Negative	20	22	12	16
Total	52	52	52	52

**Table 2.** Comparison of Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value of Crush Smears and KOH Mount With Histopathology and Culture
Diagnostic method	Sensitivity (%)	Specificity (%)	Positive predictive value (%)	Negative predictive value (%)
Crush smear vs. histopathology	77.7	75.0	87.5	60
Crush smear vs. culture	72.2	62.5	81.2	50
KOH mount vs. histopathology	71.4	70.5	83.3	54.5
KOH mount vs. culture	79.3	69.5	76.6	72.7

**Table 3.** Comparison of Pre- and Post-Therapeutic Fungal Morphological Characteristics on Crush Smears
Feature	Pre-therapeutic (n = 29)	Post-therapeutic (n = 19)	P value (McNemar Chi-square test)
Viable hyphae	26	0	< 0.0001
Fruiting bodies	7	0	< 0.004
Degenerated hyphae	3	16	0.0003
Inflammatory cells in vicinity of hyphae	0	13	0.0003
Giant cells	0	3	0.083