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Pelvic actinomycosis and IUD.

B Sehnal, J Beneš, Z Kolářová

Ceska Gynekologie

|March 9, 2019

Summary

Women with actinomyces-like organisms (ALO) on cervical Pap smears and an intrauterine device (IUD) do not require treatment or IUD removal unless symptomatic. Regular IUD replacement every five years can mitigate pelvic actinomycosis risk.

Keywords:

ALO ALO sulfur granules.IUD actinomyces actinomyces-like organisms pelvic actinomycosis sulfur granules

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Area of Science:

Gynecology
Infectious Diseases
Microbiology

Background:

Actinomycosis is a chronic infection caused by Actinomyces bacteria, often affecting the pelvic region in women.
Pelvic actinomycosis is frequently associated with long-term intrauterine device (IUD) use.
Actinomyces-like organisms (ALO) are commonly found on cervical Pap smears.

Purpose of the Study:

To review the management of women with cervical actinomyces and an IUD.
To clarify the significance of ALO detection on Pap smears.
To provide evidence-based recommendations for clinical practice.

Main Methods:

Comprehensive literature review.
Analysis of existing studies on pelvic actinomycosis and IUDs.
Synthesis of current knowledge on diagnosis and treatment.

Main Results:

Detection of ALO on Pap smears is not diagnostic of actinomycosis and does not necessitate treatment or IUD removal in asymptomatic women.
The risk of developing symptomatic pelvic actinomycosis, even with ALO on Pap smears, is very low.
Antibiotic treatment and IUD removal are generally not required for asymptomatic cases.

Conclusions:

Asymptomatic women with cervical ALO and an IUD do not need intervention.
IUDs should be replaced every five years to minimize the risk of pelvic actinomycosis.
Management should be guided by symptoms rather than solely by Pap smear findings.