Pelvic actinomycosis and IUD. 2018

B Sehnal, and J Beneš, and Z Kolářová, and M Mojhová, and M Zikán

OBJECTIVE To summarize knowledge about the mana-gement in women with proven actinomyces in uterine cervix and inserted intrauterine device (IUD). METHODS An overall review. RESULTS Actinomycosis is an uncommon but important subacute or chronic infection caused by anaerobic or microaerophilic bacteria, mainly within the Actinomyces genus. Actinomycosis can affect various organs and tissues in the human body, often manifesting draining sinuses, abscess formation and fibrosis. The pelvic form in women is the most common in the developed countries. Long-duration treatment with antibiotics can be completely effective even in cases of heavy disease. Although pelvic actinomycosis is predominantly associated with the longstanding use of intrauterine device, the risk of future symptomatic infection is extremly low even in women with a cervical Pap smear positive for actinomyces-like organisms (ALO). Therefore the identification of actinomycetes by cytology after cervical Pap smears is not diagnostic nor predictive of any disease because the actinomycetes normally reside in the female genital tract. In the absence of symptoms, patients with ALO on a Pap test do not need antimicrobial treatment or IUD removal. Nevertheless, women choosing an IUD for contraception should know that there is very low risk of developing the infection in later years after insertion. CONCLUSIONS The sources of literature conclude that removal of the intrauterine device in a patients with a positive ALO in the uterine cervix is not necessary and antibiotics treatment is not required. However, IUD must be changed at least every five years in order to limit the risk of the development of pelvic actinomycosis.

UI MeSH Term Description Entries
D007434 Intrauterine Devices Contraceptive devices placed high in the uterine fundus. Contraceptive Devices, Intrauterine,Contraceptive IUD,Contraceptive IUDs,IUD, Unmedicated,Unmedicated IUDs,Contraceptive Device, Intrauterine,Device, Intrauterine,Device, Intrauterine Contraceptive,Devices, Intrauterine,Devices, Intrauterine Contraceptive,IUD, Contraceptive,IUDs, Contraceptive,Intrauterine Contraceptive Device,Intrauterine Contraceptive Devices,Intrauterine Device,Unmedicated IUD
D002353 Carrier State The condition of harboring an infective organism without manifesting symptoms of infection. The organism must be readily transmissible to another susceptible host. Asymptomatic Carrier State,Asymptomatic Infection Carrier,Inapparent Infection Carrier,Presymptomatic Carrier State,Presymptomatic Infection Carrier,Super-spreader Carrier,Superspreader Carrier,Asymptomatic Carrier States,Asymptomatic Infection Carriers,Carrier State, Asymptomatic,Carrier State, Presymptomatic,Carrier States,Carrier, Super-spreader,Carrier, Superspreader,Carriers, Super-spreader,Carriers, Superspreader,Inapparent Infection Carriers,Infection Carrier, Asymptomatic,Infection Carrier, Inapparent,Infection Carrier, Presymptomatic,Presymptomatic Carrier States,Presymptomatic Infection Carriers,Super spreader Carrier,Super-spreader Carriers,Superspreader Carriers
D002584 Cervix Uteri The neck portion of the UTERUS between the lower isthmus and the VAGINA forming the cervical canal. Cervical Canal of the Uterus,Cervical Canal, Uterine,Ectocervix,Endocervical Canal,Endocervix,External Os Cervix,External Os of the Cervix,Uterine Cervical Canal,Cervix,Cervixes,Uterine Cervix,Canal, Endocervical,Canal, Uterine Cervical,Cervix, External Os,Cervix, Uterine,Endocervical Canals,Uterine Cervical Canals
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000190 Actinomyces A genus of gram-positive, rod-shaped bacteria whose organisms are nonmotile. Filaments that may be present in certain species are either straight or wavy and may have swollen or clubbed heads.
D000196 Actinomycosis Infections with bacteria of the genus ACTINOMYCES. Actinomyces Infections,Infections, Actinomyces,Actinomyces Infection,Actinomycoses,Infection, Actinomyces
D014626 Vaginal Smears Collection of pooled secretions of the posterior vaginal fornix for cytologic examination. Cervical Smears,Cervical Smear,Smear, Cervical,Smear, Vaginal,Smears, Cervical,Smears, Vaginal,Vaginal Smear

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