Pelvic actinomycosis in women using intrauterine contraceptive devices

Several recent reports have indicated the possible association between pelvic infection caused by Actinomyces and the use of intrauterine contraceptive devices. Seven cases of infection or colonization of the female genital tract have been detected among women using intrauterine contraceptive devices (IUD's) at Grady Memorial Hospital, Atlanta, Georgia, from March, 1975, until May, 1977. No single IUD type has been incriminated. The shortest duration of consecutive IUD use before the diagnosis was two and a half years. Six of these cases were detected incidentally at the time of endometrial or endocervical biopsy. The diagnosis in each case was made histologically. One patient presented with severe pelvic inflammatory disease and had Actinomyces identified. This is the first reported death associated with pelvic actinomycosis in a woman using an IUD. This organism must be considered as a possible pathogen whenever a patient with an IUD develops pelvic inflammatory disease.