Retained intrauterine devices and abdominal actinomycosis, diagnostic challenges from a case series

Abdominal actinomycosis is an uncommon infection that may mimic malignancy or inflammatory bowel disease, leading to delayed diagnosis. Retained intrauterine devices (IUDs) have been associated with pelvic and abdominal actinomycosis. We report four women with prolonged IUD use presenting with non-specific abdominal symptoms and varied radiological findings, including abdominal wall, pelvic and hepatic abscesses. Diagnosis was supported by microbiological and/or histopathological findings. Management included IUD removal, prolonged antibiotic therapy and, in one case, surgery. These cases highlight the diagnostic challenges of abdominal actinomycosis and the importance of considering the diagnosis in women with long-term IUD use.