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Chronic Actinomyces Infection Caused by Retained Cervical Cerclage: A Case Report
Background:
Historically, Actinomyces infection has been associated primarily with the intrauterine device. Recently, case reports associating Actinomyces with other implants have been described, including nonwoven polypropylene mesh used for urethral slings and Mersilene cerclage placements. However, there are no reported cases of chronic Actinomyces infections associated with retained Mersilene cerclage.
Case:
A 51-year-old woman, gravida 3, para 3, presented with a 10-year history of vaginal discharge and Actinomyces identified on endometrial biopsy. After failing medical treatment and undergoing a hysterectomy, the patient was found to have a retained Mersilene cerclage.
Conclusion:
This is the first case to report persistent Actinomyces infection with a retained Mersilene cerclage. No current recommendations exist for assessing full removal of cerclage. Clinicians should have a high suspicion of Actinomyces infection in a patient who presents with persistent vaginal discharge and history of cerclage placement.
Insights
Chronic Actinomyces infection can occur with retained Mersilene cerclage, a surgical mesh. This case highlights the need for high clinical suspicion in patients with persistent discharge and cerclage history.
Area of Science:
- Medical Microbiology
- Surgical Gynecology
Background:
- Actinomyces infections are historically linked to intrauterine devices.
- Recent reports associate Actinomyces with implants like polypropylene mesh and Mersilene cerclage.
- No prior cases documented chronic Actinomyces infections with retained Mersilene cerclage.
Observation:
- A 51-year-old woman presented with a decade of vaginal discharge.
- Actinomyces was identified via endometrial biopsy.
- The patient underwent hysterectomy after failed medical treatment, revealing a retained Mersilene cerclage.
Findings:
- This case is the first to document persistent Actinomyces infection associated with a retained Mersilene cerclage.
- No established guidelines exist for evaluating complete cerclage removal.
- High suspicion for Actinomyces infection is crucial in patients with persistent discharge and a history of cerclage.
Implications:
- Clinicians should consider Actinomyces in patients with chronic vaginal discharge and prior cerclage placement.
- Further research may be needed to develop diagnostic and management strategies for retained cerclage-associated Actinomyces infections.
