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Re: ActinomycesFrom: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca)Fri Mar 10 23:36:51 2006
At Fri, 10 Mar 2006, Rafael Haciski wrote: > >I received a report of actinomyces on a recent PAP in an >asymptomatic, IUD wearing, late 20's aged patient (routine annual exam). > >While my immediate reaction is to remove the IUD (copper T if I >recall correctly), am I over-reacting? >Should I leave it alone? While on one hand there is a negative >association with IUDs, Actinomyces is (although rarely reported on >routine PAPs or vaginal cultures) considered a member of normal >vaginal flora. > >What does the collective wisdom say? > >-- >Rafael Haciski MD FACOG >Palmetto, FL > I hate it when a pathologist gives incidental findings, Mr. pathologist I did the pap smear to check for dysplastic cells if there was to much bacterial overgrowth and you can't read it, well fine I will repeat it. Sure actinomyces if part of the normal flora at the tip of an IUD, but its also the normal flora the causes pelvic Actinomyosis and the law of averages will will eventually see some of these asymptomatic women get serious infections and there will be a nice record of it being there before. Fortunately with the new thin prep methods I see actinomyces, Trich. and Candida reported less often than the older swab methods of PAP taking.
--
Take care, John
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