Pelvic actinomycosis: A review and preliminary look at prevalence

Comparison of two procedures for routine IUD exchange in women with positive Pap smears for actinomyces-like organisms

“…Cytological diagnosis of actinomyces is difficult and the clinical significance of ALOs positive PAP smears is still uncertain (2,7,9,17). Several authors report a lack specificity of PAP smears in identifying actinomycetes (9,18). False -positive identification can occur in the presence of Candida, Lepthotrix, Aspergillus and Eubactrium nodatum (4,19).…”

“…In symptomatic ALOs positive IUD users consistently IUD removal and antibiotic treatment are recommended (2,8,9). The management of ALOs in the absence of significant symptoms however is difficult and controversial.…”

Pelvic Inflammatory Disease: Current notions

“…If there is no response to therapy within 72 hours patient should be reevaluated and possibly hospitalized to confirm the diagnosis and for consideration of parenteral antibiotic therapy if they are on an oral regimen. All male sex partners of women with acute PID should be evaluated for sexually transmitted diseases, and those who had sexual contact with the patient during 60 days preceding the onset of symptoms in the patient should be empirically treated with regimens effective against C.trachomatis and N.gonorrhoeae.In many circumstances the male sex partner tests positive for chlamydia or gonorrhea,but the patient receiving the therapy is negative; such results shed light on the pathogenesis of infection [26].…”

“…Colonization of the lower genital tract occurs most often in the settings of IUDs(especially in long term users)and colonization portends an increased risk of PID.Colonization is usually recognized on Pap smears showing characteristic -sulfurgranules‖.Patients can be followed expectantly with repeat Pap smears or treated for 10 to 214 days with oral penicillin. Rarely does PID need to be removed for colonization [26].Infection ensues in a small percentage of colonized women. Clinical presentation may be irregular vaginal bleeding or mild pelvic discomfort.…”

Pelvic Actinomycosis Masquerading as Malignancy

“…The opportunistic anaerobic bacterium Actinomycosis israeli is a normal part of the human flora in the oropharynx, gastrointestinal and genital tract. 1 More than 50% of actinomycosis infections occur in the craniofacial region. Pelvic infection accounts for 20% of human cases.…”