Inflammatory / infectious


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Last staff update: 13 December 2022

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PubMed search: Cervix Actinomycosis

Farnaz Hasteh, M.D.
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Cite this page: Hasteh F. Actinomycosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixactinomycosis.html. Accessed July 13th, 2024.
Definition / general
  • Also called "dust bunnies" or "Gupta bodies"
  • Rarely identified in Pap Test (< 1%)
  • Can be found in culture of 25% of asymptomatic patients
  • 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
  • Asymptomatic
  • Malodorous brown discharge
  • Pain with invasive disease and PID (pelvic inflammatory disease)
  • Removal of IUD for asymptomatic women
  • Removal of IUD and antibodies for symptomatic women
Microscopic (histologic) description
  • Tangled clumps of gram positive, non-acid fast, filamentous organisms, often with acute angle branching, sometimes showing irregular wooly appearance
  • Swollen filaments may be seen with clubs at periphery
  • Often cotton ball-like acute inflammatory response
Cytology description
  • Aggregates of pseudofilamentous material, often with acute angle branching
  • May have wooly appearance; periphery may contain swollen filaments with clubs
Cytology images

Contributed by Marilin Rosa, M.D.


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IUD related changes

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