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.
Gram stain of secretions or scrapings from device
“No organisms resembling Actinomyces spp. seen on microscopic examination”
“Organisms resembling Actinomyces spp. seen on microscopic examination”
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.