Intra-uterine device (IUD) for Actinomyces

Genital colonization and, rarely, infection by Actinomycetes spp. (most commonly A. israelii) has been associated with the use of intrauterine contraceptive devices (IUDs). This is generally identified on routine PAP smears and there is controversy about the most appropriate action. A conservative approach is advocated by many authorities as most women remain asymptomatic with IUD removal being curative for the few that develop symptoms.

The microbiology laboratory plays a small role in confirming the presence of Actinomyces spp. Secretions or scrapings from the IUD are Gram stained. Culture is not performed.

Setup

Direct Examination

Gram stain of secretions or scrapings from device

Culture

Not indicated

Interpretation Examine for the presence of branching Gram positive bacilli suggestive of Actinomyces species.
Reporting

Negative Report

“No organisms resembling Actinomyces spp. seen on microscopic examination”

Positive Report

“Organisms resembling Actinomyces spp. seen on microscopic examination”

References Gupta, P. K., Woodruff, J. D., l982. Actinomyces in Vaginal smears, JAMA 2247: 1175-76.

Valicente, J. F., Jr., et al. 1982. Detection and Prevalence of IUD-associated Actinomyces Colonization and Related Morbidity. A prospective Study of 69,925 cervical smears. JAMA 247:1149-1152.