Jones M C, Buschmann B O, Dowling E A, Pollock H M
Acta Cytol. 1979 Jul-Aug;23(4):282-6.
The association of Actinomyces with IUD wearers has been widely documented and the possibility of the recognition of actinomycetes-like organisms in routine Papanicolaou-stained cervicovaginal smears has been reported. We conducted a retrospective study of IUD wearers to determine the prevalence and significance of actinomycetes-like organisms found in such smears. Three hundred smears from current IUD wearers were rescreened for actinomycetes-like organisms. Of this group, 200 patients were from a public health family planning clinic, and 100 were private patients. The incidence for the public health group was 25.5% and for the private patient group, 8%. A case history of actinomycosis is included. Findings such as other infectious agents, abnormal cytology and symptoms are also discussed. Although the presence of Actinomyces probably represents an opportunistic infection, the threat of pelvic actinomycosis with serious complications poses a management problem to the clinician when Actinomyces is reported in a routine Papanicolaou smear. Our findings lead us to question the practicality of the earlier recommendations of IUD removal and antibiotic therapy.
放线菌与宫内节育器(IUD)使用者之间的关联已有大量文献记载,并且已有报道称在常规巴氏染色宫颈阴道涂片中有识别放线菌样微生物的可能性。我们对IUD使用者进行了一项回顾性研究,以确定在此类涂片中发现的放线菌样微生物的患病率及其意义。对300名现用IUD使用者的涂片重新筛查放线菌样微生物。在这组人群中,200名患者来自公共卫生计划生育诊所,100名是私人患者。公共卫生组的发病率为25.5%,私人患者组为8%。文中包含了放线菌病的病例史。还讨论了其他感染因子、异常细胞学和症状等发现。虽然放线菌的存在可能代表机会性感染,但当在常规巴氏涂片中报告放线菌时,盆腔放线菌病及其严重并发症的威胁给临床医生带来了管理难题。我们的研究结果使我们对早期关于取出IUD和抗生素治疗的建议的实用性产生质疑。