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Cervix-Cytology

Inflammation / parasites

Actinomycosis

Reviewer: Farnaz Hasteh, M.D., UCSD Medical Center (see Reviewers page)
Revised: 28 October 2010, last major update October 2010
Copyright: (c) 2006-2010, PathologyOutlines.com, Inc.

Definition
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● Usually caused by Actinomyces israelii, a gram positive anaerobe
● Associated with intrauterine devices (Obstet Gynecol 1996; 87:142)

Terminology
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● Also called “dust bunnies” or “Gupta bodies”

Epidemiology
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● Rarely identified in Pap test (<1%)
● Can be found in culture of 25% of asymptomatic patients

Etiology
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● Actinomyces Israeli is most common subtype (normal flora of the mouth and bowel)
● Associated with IUD (common) or rarely with other objects (pessaries, tampon)
● Copper containing IUD and long term use are major risk factors

Clinical features
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● Asymptomatic
● Malodorous brown discharge
● Pain with invasive disease and PID (pelvic inflammatory disease)

Treatment
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● Removal of IUD for asymptomatic women
● Removal of IUD and antibiotics for symptomatic women

Micro description
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● Gram positive non-acid fast branching filamentous bacteria

Cytology description
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● Aggregates of pseudofilamentous material, often with acute angle branching
● May have wooly appearance; periphery may contain swollen filaments with clubs

Cytology images
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Actinomyces

IUD related changes

Differential diagnosis
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● Other filamentous organisms (Leptothrix, Aspergillus)
● Cockleburs (degenerate radiate crystals associated with pregnancy, IUDs, birth control pills)

End of Cervix-cytology > Inflammation / parasites > Actinomycosis

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