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  • Title: The prevalence of actinomycetes-like organisms found in cervicovaginal smears of 300 IUD wearers.
    Author: Jones MC, Buschmann BO, Dowling EA, Pollock HM.
    Journal: Acta Cytol; 1979; 23(4):282-6. PubMed ID: 294771.
    Abstract:
    The association of Actinomyces with IUD wearers has been widely documented and the possibility of the recognition of actinomycetes-like organisms in routine Papanicolaou-stained cervicovaginal smears has been reported. We conducted a retrospective study of IUD wearers to determine the prevalence and significance of actinomycetes-like organisms found in such smears. Three hundred smears from current IUD wearers were rescreened for actinomycetes-like organisms. Of this group, 200 patients were from a public health family planning clinic, and 100 were private patients. The incidence for the public health group was 25.5% and for the private patient group, 8%. A case history of actinomycosis is included. Findings such as other infectious agents, abnormal cytology and symptoms are also discussed. Although the presence of Actinomyces probably represents an opportunistic infection, the threat of pelvic actinomycosis with serious complications poses a management problem to the clinician when Actinomyces is reported in a routine Papanicolaou smear. Our findings lead us to question the practicality of the earlier recommendations of IUD removal and antibiotic therapy. 300 Papanicolaou smears from current IUD wearers were rescreened to determine the prevalence of actinomycetes. Of the 300 patients, 59 showed actinomycetes-like organisms in cervicovaginal smears. Of the 59 positive cases, 51 (of 200, 25%) were from public health clinics and 8 (of 100, 8%) were from private patients. Of 21 patients complaining of irregular bleeding, only 4 had positive actinomycete cultures. In cases positive for the organisms there was no correlation of prevalence found with the phase of the menstrual cycle or with menstruation itself. A case history of actinomycosis is included. Although the presence of Actinomyces probably represents an opportunitistic pathogenic infection, management of this infection is important to eradicate the threat of pelvic actinomycosis. In the case history described, however, antibiotic therapy failed, and a complete abdominal hysterectomy was performed.
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