[Actinomycosis as a complication of intrauterine device use].
BACKGROUND
Infections in the female pelvis can present clinically in various ways and the causing agent can be difficult to trace. In this paper we present updated knowledge about infections caused by the bacterium Actinomycosis in relation to intrauterine device use.


METHODS
The article is based on own clinical experience and literature identified through a non-systematic search in PubMed.


RESULTS
Actinomycosis in the female pelvis is a rare disease and the pathogenesis is still obscure. The incidence in Scandinavia has not been established. The infection can cause tumor-like structures resulting in bowel and urinary obstruction. The bacteria can be difficult to detect. Preferably the agent should be demonstrated in a specimen from the infected area to ensure the correct diagnosis. However, Actinomyces is a normal inhabitant of the gastrointestinal tract and is also present in 5 % of cervical smears from healthy women. The optimal treatment of actinomycosis is long-term treatment with penicillin, alone or in addition to surgery.


CONCLUSIONS
To avoid unnecessary and potentially difficult surgical procedures, actinomycosis should be a differential diagnosis when women with a longstanding intrauterine device develop signs of infection in addition to a pelvic mass. Intrauterine devices should be replaced every fifth year and should be removed at menopause.
Valbø
Annelill
A
Kvinneklinikken, Sykehuset Asker og Baerum, Postboks 83, 1309 Rud, Norway. annelill.valbo@vestreviken.no
Rønning
Else Johanne
EJ
Aaberg
Morten
M
D000196:Actinomycosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D020878:Device Removal; D003937:Diagnosis, Differential; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects*; D034161:Pelvic Infection / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*