Actinomycotic Endomyometritis Associated with a Long-Term Use of Intrauterine Device Lasting for 42 Years

In women, pelvic actinomycosis is closely associated with prolonged use of the intrauterine devices (IUD). A 70-year old female presented with intermittent blood-stained vaginal discharge. An analysis of her history revealed, she was inserted with an IUD 42 years ago, but it has remained in situ untill now. Curettage of the uterus was done, but an IUD was firmly attached inside the cavity and there was not able to remove it. A biopsy material consisted of the large round and oval granules of filamentous and mycelium-like microorganisms. They showed strong positivity with Periodic acid–Schiff stain and Gömöri methenamine silver stain. Histopathology was consisted with uterine actinomycosis. A total abdominal hysterectomy with bilateral adnexectomy was performed. The uterus contained a retained plastic IUD. Microscopic investigation revealed a diffuse chronic active endomyometritis with sporadic Actinomycetes colonies. Wearing an IUD continuously for very long periods of time can lead to actinomycotic infection, which may manifest for many years after its application. All IUD users have to keep in mind regular gynecological check-ups to avoid the complications of a retained and “forgotten” IUD.