PIP: The use of IUDs can contribute to the incidence of actinomycosis. Actinomycosis, formerly regarded as a fungal disease, is now known to be caused by bacteria of the genus Actinomyces. The diagnosis of actinomycosis is difficult because the disease usually does not manifest itself in any specific symptoms. The most common diagnostic method uses histological slides. It is difficult to do cultures, and they require good anaerobic techniques. Pap smears are usually reliable but not unambigous since, in a heavy concentration of bacteria, Actinomyces may be mistaken for similar organisms. More specific results can be obtained using immunofluorescence. Before 1973, actinomycosis was considered a rare disease, a secondary one often resulting from an outbreak of appendicitis. Now it is commonly believed that women who have worn a plastic IUD for at least 2 years, and possibly women whose copper IUDs have not been changed for some time, are highly susceptible to actinomycosis. The 1st case of genital actinomycosis was discovered in 1973, with 10 cases reported in 1975 in which the patients had been using IUDs for at least 2 years. In 1979, 2 deaths from genital actinomycosis were reported. Also in 1979, a study reported actinomycosis in 19% of 330 women using IUDs. 1980 study found the disease in 40 of 128 women using plastic IUDs and 2 out of 165 women using copper IUDs for over 2 years. In Finland, physicians have always favored copper IUDs and frequent changes of any kind of IUD. A Swedish physician advocated in 1980 that all plastic IUDs be removed, that copper IUDs be changed frequently, and that no IUD be inserted if any gynecological infection is present. Annual pap smears are advisable and, only where necessary, antibiotics should be taken and IUDs removed. Actinomycosis can be cured with penicillin, tetracyclines, and erythromycin.