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  • Title: Actinomyces infection associated with intra-uterine device.
    Author: Santa MC, Buschmann BO, Daniel SJ.
    Journal: J Med Assoc State Ala; 1978 May; 47(11):31-3. PubMed ID: 670841.
    Abstract:
    Since 1926 numerous cases of Actinomyces genital infection have been reported. An association with the IUD, metallic or polyethylene, has become evident after several severe complications in patients using this contraceptive method. The route of entry, in addition to direct spread from the bowel, may be direct extention across the anal area and perineum upward through the vagina, endometrial cavity to the fallopian tubes and ovaries. The vaginal string of the IUD is thought to break the protective barrier of the cervical mucus, permitting transit of organisms from the vagina into the uterus and from there to the tubo-ovarian complexes. Vascular spread is another possible route of infection. The uterine cavity in these patients becomes a good culture medium for these organisms. In patients wearing IUDs for 1 year, 13% presented with chronic endometritis and 65% showed recognizable endometrial change, manifested by diffuse or focal round-cell infiltration. Lower abdominal pain, heavy yellow discharge, and fever and weight loss were the symptoms most frequently presented with infection by Actinomyces. A new cytologic approach of preparing smears from freshly removed Lippes loops from symptomatic patients has been reported. Resulting samples have numerous macrophages and fibroblasts. This could prove a good method for identifying Actinomyces in the patients harboring this orgasm. The case of a 54-year-old black female having worn an IUD for 12 consecutive years is summarized.
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