ASSOCIATION OF THE INTRAUTERINE DEVICE AND PELVIC INFLAMMATORY DISEASE: A RETROSPECTIVE PILOT STUDY

Actinomycosis is a chronic disease that is characterized by the formation of abscesses, fistulas and dense fibrous tissue at the site of involvement. Its distribution is worldwide. However, pelvic actinomycosis has increased in frequency and has been associated with abdominal surgery, intestinal perforation or trauma, due to the destruction of the muscular barrier. The clinical elements of suspicion are the latency of months and even years of symptoms and the history of being a carrier of an intrauterine device. Actinomyces israelli is a rare etiological agent of pelvic inflammatory disease, so it is difficult to reach the diagnosis. A case report is made of a 48-year-old patient with an intrauterine device older than 5 years, who entered the emergency department with abdominal pain syndrome and 7-day evolutionary fever accompanied by dyspareunia. She was hospitalized for antibiotic treatment, presenting an unsatisfactory evolution, with increased leukocytosis and persistent abdominal pain. An exploratory laparotomy with abdominal hysterectomy was performed. The histopathological diagnosis was pelvic inflammatory disease due to actinomyces. We must always suspect in the presence of a pelvic inflammatory disease in any of its clinical forms, the presence of actinomyces as one of the possible causative germs, especially in patients with intrauterine device for more than 5 years.

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Pelvic Inflammatory Disease and the Intrauterine Device: A Causal Relationship?

International Journal of Gynecology & Obstetrics ◽

10.1002/j.1879-3479.1980.tb00198.x ◽

1980 ◽

Vol 17 (5) ◽

pp. 504-514 ◽

Cited By ~ 8

Keyword(s):

Pelvic Inflammatory Disease ◽

Causal Relationship ◽

Inflammatory Disease ◽

Intrauterine Device

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Pelvic Inflammatory Disease and Tubo-Ovarian Abscess

10.1093/med/9780199976805.003.0040 ◽

2016 ◽

Author(s):

John Holst

Keyword(s):

Pelvic Inflammatory Disease ◽

Inflammatory Disease ◽

Intrauterine Device ◽

White Blood Cells ◽

Health Department ◽

Immunocompetent Patient ◽

Local Health ◽

Hiv Patients ◽

Gastrointestinal Complaints ◽

Ovarian Abscess

Pelvic inflammatory disease (PID) consists of inflammation in various parts of the upper genital tract and includes endometritis, salpingitis, tubo-ovarian abscess (TOA), and/or pelvic peritonitis. Overt acute PID patients typically present as ill-appearing with pain, fever, chills, purulent vaginal discharge, nausea, vomiting, and elevated white blood cells. “Silent” PID presents with dyspareunia, irregular bleeding, and urinary and gastrointestinal complaints. Bacterial vaginosis (BV) and associated microorganisms are present in acute PID patients. PID coverage is focused on a polymicrobial infection. HIV patients typically have more severe symptoms and are more likely to have a TOA than an immunocompetent patient, but HIV alone does not mandate hospital admission nor does parenteral therapy improve outcomes compared to non-HIV patients. Gonorrhea and chlamydia cases must be reported to the local health department; it is not mandatory for PID patients to remove an intrauterine device at the time of diagnosis.

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