A systematic review of fungi isolated from formalin-preserved human and animal cadavers: A potential health concern to exposed students and technicians

Abstract

Fungal contamination of formalin-fixed cadavers raises potential health concerns. We aimed to systematically search published literature to explore the fungi that commonly contaminate formalin-fixed cadavers to estimate the size of the problem and all dynamics involved. Our search retrieved 20,273 citations and we retained eight descriptive cross-sectional studies that met our selection criteria, published between 2002 and 2022. The results indicate that, worldwide, there is a significant problem of fungal contamination in formalin-preserved cadavers. The majority of contaminated cadavers were human cadavers and only one citation studied animal cadavers. The formalin concentrations used in the tanks were 5–14 %. Studies mostly used swabs to collect samples and tested them using fungal culture. The fungi isolated included Aspergillus spp, Penicillium spp, Trichophyton spp, Epidermophyton spp, Cryptococcus spp, Candida spp, Fusarium spp., Purpureocellium spp, Chrysonilia spp, Trichoderma spp, Microsporum spp, and Cladosporium spp. The most suspected sources of contamination were air, water, and the bodies. Aspergillus, Trichophyton, and Penicillium species were the most common fungal contaminants isolated. Fungal contamination of cadavers can lead to financial loss and dangerous health outcomes for exposed individuals. The effective concentration of formalin remains unknown. Students/technicians should use personal protective equipment, such as face masks and gloves, while handling cadavers.