2024 Clinician Corner - A premenopausal woman with fragmentation of a nonexpired copper intrauterine device and concomitant presence of Actinomyces species
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
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The planners and faculty for this activity have no relevant financial relationships to disclose. The patient consented to the publication of this report.
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Expiration date:
Credit eligibility for this article is set to expire on November 1, 2025.
Learning Objectives
After completing the article, the learner should be able to:
- Identify which organisms are most likely to be associated with an intrauterine device
- Identify which imaging modality is the most sensitive at identifying retained copper.
Key points:
- 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.
Blair Sprong, DO, Garrett Schwab, MD, and Stephen J. Titus, MD
Department of Family Medicine, Baylor University Medical Center, Dallas, Texas, USA
Corresponding author:
Stephen J. Titus, MD, 4401 Coit Rd., Ste. 409, Frisco, TX 75035 (e-mail: stephen.titus@bswhealth.org)
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