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Case Reports
. 2024 Jun 13;37(6):976-978.
doi: 10.1080/08998280.2024.2365074. eCollection 2024.

A premenopausal woman with fragmentation of a nonexpired copper intrauterine device and concomitant presence of Actinomyces species

Blair Sprong  1 , Garrett Schwab  1 , Stephen J Titus  1
Affiliations
Case Reports

A premenopausal woman with fragmentation of a nonexpired copper intrauterine device and concomitant presence of Actinomyces species

Blair Sprong et al. Proc (Bayl Univ Med Cent). .

Abstract

Actinomyces spp. has been shown to form biofilms when exposed to copper, possibly enhancing its degradation. Fragmentation and migration of the copper coil on an intrauterine device (IUD) is rare, but the concomitant presence of Actinomyces spp. may increase its incidence. We present the first case of a fragmented copper IUD within its lifespan of 10 years, with documented Actinomyces genitourinary tract colonization in a premenopausal woman.

Keywords: Actinomyces; intrauterine device.

Plain language summary

Actinomyces spp. are more prevalent in the urogenital tract of women with IUDs due to the local tissue injury from the device inside the uterus, which creates an anaerobic environment that allows this organism to flourish.Actinomyces spp. can form biofilms when exposed to copper, potentially enhancing its degradation, leading to fragmentation.Patients with a copper IUD and Actinomyces identified on routine or symptomatic cervical sampling should be counseled regarding potential enhanced copper degradation, fragmentation, and migration of the copper coil.

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Conflict of interest statement

The planners and faculty for this activity have no relevant financial relationships or funding to disclose. The patient consented to publication of this case report.

Figures

Figure 1.
Figure 1.
(a) Paragard IUD. (b) Paragard IUD postremoval in specimen container. Red arrows: fragmentation of the copper. Red box: knotted strings with buildup of black debris. Red braces: missing copper coil on long arm.
Figure 2.
Figure 2.
Management algorithm of Actinomyces spp. on cervical swab of patients with copper IUD in place. For this article, we are only discussing results for Actinomyces spp. identified on cervical sampling; however, if any other infectious organism is present on cervical sampling please treat appropriately.
See this image and copyright information in PMC

References

    1. Patai K, Balogh I, Szarvas Z.. Clinicopathological problems of the local tissue effect of the copper-releasing intrauterine contraceptive device (IUD). I. General characteristics of the copper-containing IUD (clinical study). Acta Chir Hung. 1989;30(2):129–132. - PubMed
    1. Berthou J, Chrétien FC, Driguez PA.. Dégradation in utero des DIU au cuivre en fonction du temps. Le phénomène de corrosion métallique. Etude au microscope électronique à balayage [Degradation of copper IUDs in utero. The process of metallic corrosion. A scanning electron microscope study]. Gynecol Obstet Fertil. 2003;31(1):29–42. doi:10.1016/s1297-9589(02)00013-9. - DOI - PubMed
    1. Dubovis M, Rizk N.. Retained copper fragments following removal of a copper intrauterine device: two case reports. Case Rep Womens Health. 2020;27:e00208. doi:10.1016/j.crwh.2020.e00208. - DOI - PMC - PubMed
    1. Carrillo M, Valdez B, Vargas L, et al. . In vitro Actinomyces israelii biofilm development on IUD copper surfaces. Contraception. 2010;81(3):261–264. doi:10.1016/j.contraception.2009.09.008. - DOI - PubMed
    1. Evans DT. Actinomyces israelii in the female genital tract: a review. Genitourin Med. 1993;69(1):54–59. doi:10.1136/sti.69.1.54. - DOI - PMC - PubMed

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