Association of actinomyces and intrauterine contraceptive devices.

We analyzed the clinicopathologic aspects of 19 cases of actinomycosis associated with intrauterine devices (IUDs) seen and treated at hospitals affiliated with the State University of New York at Buffalo between 1972 and 1982. Clinical manifestations included the following: (1) asymptomatic IUD-associated Actinomyces colonization, (2) endocervicitis, (3) endometritis, (4) endometritis with salpingitis and/or tuboovarian abscesses and (5) abdominopelvic abscesses. No consistent relationship was found between the total peripheral lymphocyte count and/or degree of histologic lymphocytic reaction and the clinical picture. Abnormal uterine bleeding and/or discharge, pain, fever and abdominopelvic masses were among the symptoms and signs encountered. Patients with endocervicitis and/or endometritis responded to removal of the IUD, dilatation and curettage and antibiotic therapy for two to four weeks. Those who developed abscesses were treated successfully with surgical drainage and added antibiotic treatment.