[Reactive and areactive actinomycosis infection of the female genitals and differentiation of pseudoactinomycosis].

Actinomycotic infections of the female genital tract are rare. In relation of clinical symptoms and therapeutical implications, reactive and non-reactive infections can be distinguished. During a period of seven years we observed five reactive infections. All these cases with tubo-ovarian abscesses (TOA) were seen in women using intrauterine devices (IUD) for 9.8 years on average. 9.1% of all TOA in this period were caused by actinomyces. Ten cases showed a non-reactive infection (colonisation). The frequency was 1.9%. In three cases pseudosulfurgranules (pseudoactinomycotic granules) were identified histologically by PAS-, Grocott-and Kossa-staining). One case showed a bacterial infection of a mucinous cystadenofibroma of the ovary with colonization of microorganisms similar to cases of botryomycosis in lung and other organs. Reactive infections require antibiotic therapy. Reimplantation of IUD should be done after 4 to 8 weeks, even in areactive infections. In specimens with pseudosulfurgranules no therapy is necessary.