Out-of-date IUD leads to an infection in 54-year-old
This article highlights the case of a 54-year-old woman infected with actinomycosis because of an out-of-date IUD. She presented to the emergency with complaints of weight loss, pain, fevers and difficulty walking that had been going on for a few months. Physical examination showed a tender abdomen with a palpable lump in the lower left quadrant of the abdomen. For further evaluation doctors advised a CT and blood work. The CT scan findings were significant for abscesses around the IUD. Blood tests showed an increased number of white blood cells, consistent with an infection. The infection had spread to the pelvis and left hip joint.
A. israelii are gram positive colonial bacteria that are found in the vaginal tracts of even healthy people. However, the bacteria can form an active infection known as actinomycosis under favourable conditions for the bacteria to grow. Sample analysis confirmed the presence of A. israelii. Doctors treated the patient with a course of antibiotics. And she showed full recovery without any lasting complications.
The IUD that led to the infection was reportedly made out of plastic and should be removed every 5 years. This woman had it inserted 2 decades ago and hadn’t replaced it since then. The longest lasting IUDs are made out of copper coils, however, these should also be replaced every 12 years. Other than posing as a risk for infections, out-of-date IUDs are also an ineffective form of contraception.
“Pelvic actinomycosis occurs in more than 85% of cases where the IUD has been used for more than 3 years and is more common in users of plastic IUDs than copper IUDs,” said study author Noriko Arakaki to Gizmodo. “We consider that the long-term use of IUDs is a factor in this case.”
“Secondly, it is important that the patient understands that the IUD must be used properly, that regular outpatient visits are necessary, and that it must be replaced at the appropriate time,” she added
Source: NEJM
