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Is ALO (Actinomyces-like organisms) a sexually transmitted disease (STD)? #308/6

Two paragraphs found in Contraceptive Technology answer your question.   They were written by Dr. David Grimes of Family Health International and the University of North Carolina in Chapel Hill.  They are as follows:



Several decades ago, a pseudo-epidemic of genital actinomycosis occurred among IUD users.  Cytologists and cytopathologists began reporting Actinomyces organisms on routine cytology smears, creating alarm and confusion.  Current evidence supports the following points:    

  • The Papanicolaou smear is an invalid test for Actinomyces.
  • The presence of Actinomyces-like organisms on Papanicolaou smear does not predict clinical illness.
  • Actinomyces species are normal inhabitants on the female genital tract.
  • Vaginal culture is not helpful in diagnosing actinomycosis.
  • Pelvic actinomycosis is a very rare, serious, and poorly understood infection.

An asymptomatic IUD user who has "Actinomyces-like organisms reported on Papanicolaou smear should be notified and informed about the significance of the finding.  If she is asymptomatic, nothing more need be done.  If she has evidence of infection, remove the device and prescribe a course of oral antibiotics.  The reason for removal is that, unlike usual gynecological pathogens, this genus of bacterium preferentially grows on foreign bodies.  Actinomyces species are sensitive to a variety of antibiotics, including penicillin.  [Grimes ? 2004]


In some Actinomyces-like organisms can be present in completely asymptomatic women or may cause, rarely, a very serious form of pelvic inflammatory disease.


Key Words:  Actinomyces, organisms, Papanicolaou smear, infection, oral antibiotics, foreign bodies, penicillin                                                          


Grimes D A. Intrauterine devices (IUDs) et al. Hatcher RA, Trussell J, Stewart F. IN Contraceptive Technology 18th Edition, Page 502; Ardent Media Inc. 2004.


Posted 3-3-2006

Updated 3-30-2006


Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA

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