A Spinal Epidural Abscess Complicating an Intrauterine Contraceptive Device

Rare cases of spinal epidural infection require immediate medical diagnosis and treatment as this form of infection could be fatal. Of 250 cases reported so far none had been associated with IUD. This study involved a 28-year old female who had a Dalkon shield insertion in 1974 and 5 days later developed serious complications which necessitated immediate surgical operation (a myelogram revealed a complete block in the spinal canal; laminectomy exposed a profuse green pus in the epidural space; surgical decompression and antibiotic therapy were prescribed for the patient). Fortunately the patient recovered fully two weeks after the operation. This is the 1st reported case of a spinal epidural abcess resulting from use of an IUD. A high incidence of pelvic inflammatory disease and infection had been associated with the prolonged presence of the device in the uterus. Burnhill (1973) reported on the syndrome of progressive endometritis for long-time IUD users. Pelvic infection may be carried via Batsons venous plexus to the thoracic spinal canal the common site for epidural abcess. Staphylococcus aureus was the common finding (Gasul 1935) as in this case.