Abstract

PIP: To date, actinomycetes have been identified in 540 vagino-pancervical (Fast) smears from 520 women. In each case, a foreign body has been present, usually an IUD (517 cases). The Dalkon Shield preponderates, perhaps reflecting physician preference at the center. IUD usage duration has varied from 6 weeks to 13 years. Approximately 25% of symptomatic IUD users requesting treatment have cytologic evidence of actinomycetes. The preoperative diagnosis of pelvic actinomycetes was suggested in most cases based on cytologic evidence alone. Immunofluorescent studies have been performed in 266 cases with species-specific antisera, and Actinomyces israelii identified in 250. Protozoal organisms in the Fast smears have been noted in 8 cases (1.5%) and are commonly intimately associated with Actinomyces. It is agreed that the oropharnyx serves as the possible source of lower genital tract Actinomyces infection. In such cases, IUD removal and antibiotic treatment are recommended.