Actinomycosis and intrauterine contraceptive devices: the clinicopathologic entity.

Although the IUD is considered a safe and effective form of contraception long-term use increases risk of pelvic inflammatory disease (PID) often of proven bacterial origin. Of IUD-related pelvic infection the most destructive are those caused by the genus Actinomyces. 9 cases of pelvic actinomycosis in IUD wearers are described by the authors. Actinomyces organisms were found in tissues from all 9--in cervicovaginal smears material adherent to the IUD the endometrium or tuboovarian abscesses. The clinicopathological features of the IUD-associated actinomycotic pelvic disease are described. The cases were compared with other cases in the literature which are clearly identifiable in terms of symptoms diseased tissue and histologically or bacteriologically proven actinomyces organism. Duration of IUD use and demonstrated relationship between IUD usage and infestation of vagina with Actinomyces organisms appear to be the most important pathogenic factors. Early diagnosis and appropriate antibiotic therapy are important in the management of IUD-associated PID. IUDs should also be changed at least every 3 years and the removed IUD should be examined by a pathologist.