Actinomyces-Like Organisms in Cervical Smears from Women using Intrauterine Contraceptive Devices

Genital actinomycosis andActinomyces israelii in the female genital tract

“…In 1976 Gupta et al [3] reported on the occurrence of Actinomyces-like organisms (ALOs) in Papanicolaou-stained cervico-vaginal smears of IUD users. Other groups [4,5,6] confirmed their findings and it was suggested that women with ALOs in smears were at risk for developing genital actinomycosis.…”

“…Other authors have confirmed their findings. ALOs have been identified in frequencies varying from 1-20% in different materials of IUD users [4,5,6,25,26]. In a review of twelve different articles on the subject where a total of 187600 women without IUDs had been investigated only two cases of ALOs were identified [21].…”

“…A highly significant correlation existed between the finding of ALOs and the use of IUDs. Duguid et al [4] found the ALOs more commonly among women using plastic IUDs and suggested that the weak antimicrobial action of copper in combination with the progressive calcium encrustations that occur on IUDs over time, might explain this. Keebler et al [26] found that ALOs occurred more frequently with increasing duration of IUD use.…”

“…Duguid et al [4] suggested that the increasingly calcified deposits of cellular debris and organic material that are found with increased duration of IUD use were a condition for growth of Actinomyces. Electronmicrographs of IUDs have shown bacteria adherent to calcified deposits on IUDs [14,28].…”

Actinomyces on a papanicolaou smear following a radical trachelectomy

“…Intrauterine contraceptive device users with actinomyces-like organisms on a smear are more likely to have clinical and cytological evidence of pelvic inflammation 5,6 . Actinomyces pelvic infection is rare but the sequelae include abdominal pain, vaginal discharge, bleeding per vaginam, endometritis, endocervicitis salpingitis and tubo-ovarian abscess.…”