Actinomycins and intrauterine contraceptive devices: the clinicopathologic study

Since their widespread introduction in the early 1960s, IUD have been considered effective and safe. Early studies revealed the ability of the cavum uteri to regain bacteriologic sterility within 4 weeks of insertion. However, experience with long-term use indicates an enhanced risk of pelvic inflammatory disease, often of proven bacterial origin. Of these pelvic infections the most pernicious are those caused by Actinomyces. We present nine cases of actinomycotic female genital tract infection encountered in the past 3 years. The features of a distinct clinicopathology entity of IUD-associated actinomycotic pelvic disease are described. This disease is one of subtle protean manifestations and is not often diagnosed preoperatively. The most significantly pathogenic factors appear to be the duration of IUD use and the demonstrated relationship between IUD usage and infestation of the vagina with Actinomyces organisms.