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actinomyces - like organisms (on cervical smear)

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  • Actinomyces are part of the normal vaginal flora - however Actinomyces is rarely detected in the absence of intrauterine contraceptive devices (IUCDs) (1)
    • in the period 1990-95 there were 247 reports of Actinomyces to the PHLS Communicable Diseases Surveillance Centre - of which 133 were A Israeli - in the vast majority of cases there were no details of serious infection recorded - therefore in these cases the Actinomyces isolated appears to have been merely colonisers of the female genital tract
    • in the period 1990-95 there were reports of 10 pelvic infections caused by Actinomyces. Eight infections were with A israelii - two pyometria, two cases of PID, one omental infection and one ovarian abscess - all in IUCD users. There were two other ovarian abscesses due to A israelii where the use/non-use of an IUCD was not recorded. There were also one ovarian abscess and one case of actinomycosis associated with Actinomyces organisms but the species of Actinomyces was not speciated

Removal of IUCDs in patients with pelvic or abdominal actinomycosis is recommended