'Forgotten' intrauterine device leading to actinomycotic pyometra--13 years after menopause

Area of Science:

• Gynecology
• Infectious Diseases
• Medical Case Reports

Background:

• Intrauterine devices (IUDs) are common contraceptives.
• Long-term retention of IUDs can lead to complications.
• Postmenopausal complications related to retained IUDs are less frequently reported.

Observation:

• A postmenopausal woman presented with Actinomyces israelii infection and pyometra.
• The patient had an asymptomatic intrauterine device (IUD) retained for 22 years.
• Complications developed 13 years after menopause.

Findings:

• The retained 'forgotten' IUD was identified as the source of Actinomyces israelii infection.
• Pyometra developed secondary to the chronic infection.
• The case highlights a rare but severe complication of long-term IUD retention.

Implications:

• Ensuring removal of IUDs after their intended use is vital, regardless of symptoms.
• Clinicians should consider retained IUDs in the differential diagnosis for postmenopausal women with gynecologic infections.
• This case underscores the importance of device tracking and patient counseling regarding IUD removal.