BACKGROUND: Actinomyces infection is well-documented in intrauterine devices but has not been previously associated with hysteroscopic sterilization using coil inserts. Additionally, abscesses associated with these implants have been observed in few cases.
CASE: A 31-year-old multiparous woman with a history of hysteroscopic sterilization with coil inserts 18 months previously presented with several weeks of pelvic pain. Despite percutaneous drainage of intra-abdominal abscesses, her pain and fevers persisted. Blood cultures were positive for Actinomyces infection, and exploratory laparotomy demonstrated abscesses at both coil sites.
CONCLUSION: When a causative organism cannot be identified or the when patient does not respond to standard antibiotic therapy, Actinomyces infection should be considered because prolonged antibiotic therapy is necessary.
Actinomyces infection should be considered in patients with treatment-resistant pelvic infections and a history of hysteroscopic sterilization with coil inserts.
Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Corresponding author: Janelle B. Pakish, Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756; e-mail: firstname.lastname@example.org.
Financial Disclosure The authors did not report any potential conflicts of interest.