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Pelvic actinomycosis: a review and preliminary look at prevalence

J Lippes1

  • 1Department of Gynecology and Obstetrics, School of Medicine, State University of New York at Buffalo, USA.

American Journal of Obstetrics and Gynecology
|February 13, 1999
PubMed

Insights

Actinomycetes commonly reside in the female genital tract. Their presence, even with intrauterine devices, does not indicate disease, negating the need for device removal or antibiotics without infection evidence.

Area of Science:

  • Gynecology
  • Microbiology
  • Pathology

Background:

  • Actinomycetes are normal flora in the female genital tract.
  • Pelvic actinomycosis is a rare condition with unclear pathogenesis.
  • The clinical significance of actinomycetes detection requires clarification.

Purpose of the Study:

  • To review the literature on pelvic actinomycosis.
  • To clarify the diagnostic and clinical implications of detecting actinomycetes in the female genital tract.
  • To evaluate the necessity of interventions like IUD removal or antibiotic treatment.

Main Methods:

  • Literature review of studies on pelvic actinomycosis.
  • Analysis of diagnostic techniques including Papanicolaou smears and cultures.
  • Evaluation of clinical evidence regarding intrauterine contraceptive device (IUD) association and treatment.

Main Results:

  • Identification of actinomycetes in the vagina or cervix is not diagnostic or predictive of disease.
  • Removal of IUDs in patients with positive cultures is not routinely necessary.
  • Antibiotic treatment is not required in the absence of confirmed pelvic infection.

Conclusions:

  • The mere presence of actinomycetes in the female genital tract does not signify pelvic actinomycosis.
  • Interventions such as IUD removal or antibiotic therapy should be based on clinical evidence of infection, not solely on positive cultures.
  • Further research into the pathogenesis of pelvic actinomycosis is warranted.

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