Title: Actinomyces and the IUD.

POPLINE Document Number: 120761

Author(s):

Fiorino AS

Source citation:

CONTEMPORARY OB / GYN, 1997 Feb;42(2):78, 80, 85 passim.

Abstract:

Recent studies suggest that female pelvic actinomycosis occurs most commonly in IUD users. In such women, actinomycosis is considered to arise as an ascending infection originating in the perineum, or through ano- and orogenital contact. Actinomycotic infections related to IUD use range from mild endometrial inflammation to pelvic inflammatory disease with abscess formation. Most women who develop abscesses have been wearing an IUD for an average of 8 years, suggesting that risk increases with duration of IUD use. Other factors associated with actinomycosis in IUD users include the use of plastic rather than copper devices, lower socioeconomic status, and increased symptoms such as abdominal pain and vaginal discharge. The primary initial treatment should be high-dose penicillin for 6-12 months. The diagnosis of pelvic actinomycosis in an IUD user who presents with abdominal pain or a pelvic mass can be confirmed by aspiration, ultrasound, biopsy of involved tissue, or examination of tissue adhering to a removed IUD. Samples should be examined by standard histologic means, anerobic culture for 2 weeks, and immunofluorescence. Papanicolaou smears have been used for screening purposes; however, failure to detect actinomycosis on Pap smear does not exclude the possibility of an ongoing pelvic process and organisms detected through this means are often clinically insignificant, disappearing without treatment after IUD removal.

Keywords:

Literature Review
IUD Side Effects
Bacterial and Fungal Diseases
Pelvic Inflammatory Disease
Screening
Treatment
Side Effects
IUD
Contraceptive Methods
Contraception
Family Planning
Infections
Diseases
Reproductive Tract Infections
Examinations and Diagnoses