The significance of the presence of actinomycetes in Papanicolaou smears of IUD users.

Hanf and Hanf in 1954 reported the presence of actinomycetes on routine examination of the vaginal flora in 4% of women with poor vaginal hygiene. Of late the association of actinomycetes with the use of IUDs has been widely documented. It has been recommended that the IUD be removed and/or antibiotic therapy be administered when these organisms are recognized in vaginal smears. A study was undertaken at Magee Womens Hospital in Pittsburgh to define the population of IUD users colonized by actinomycetes and the optimal management of such patients. Cervicovaginal smears from 330 patients using an IUD were reviewed. Actinomycetes-like organisms were present in 70 cases (22%). Ad additional 150 patients with actinomycetes-like organisms were identified from current cytologic material. In 50 patients Papanicolaou smears of previous years were available for review and actinomycetes-like organisms were present in previous Papanicolaou smears of 26 of 50 patients (52%) for a period ranging from 1-6 years. Clinically none of these patients required medical intervention. Study findings indicate that these are opportunistic organisms; their presence in the lower genital tract does not require drastic therapy.