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A woman’s intrauterine device was kept in it for 20 years and was covered with bacteria, causing a serious infection

The image on the left is a CT scan of the patient. The arrow points to her IUD, and the asterisk indicates a nearby abscess. The picture on the right is the IUD after removal. The yellow substance is believed to be the bacteria that caused her infection.

The picture on the left is a CT scan of the patient, with the arrow pointing to her intrauterine device An asterisk indicates an abscess nearby.The correct image is After removing the IUD, the yellow substance was believed to be the bacteria that caused her infection.
picture: Noriko Arakaki and Yusuke Oshiro / NEJM

Japanese doctors reported this week that a woman who had placed an intrauterine device (IUD) in her body for more than 20 years could cause a serious infection that led to her being taken to the emergency room. It was discovered that this expired contraceptive device was surrounded by bacteria, which caused her to have fever and abdominal pain for several months.Once the woman has removed the IUD and received long-term antibiotic treatment, Her symptoms disappeared.

Intrauterine device Yes T-shaped device, Not more than one-quarter, insert this The uterus is also used as long-term contraception.This can happen by releasing hormones from the device or from the copper used in certain products (Copper makes the uterus unfit for sperm).The IUD is very effective, Prevent 99% of pregnancy.But like all drugs, they have shortcoming.For example, the initial insertion process can be very painful, and some people Symptoms such as increased bleeding or cramps may appear after a few months.They may also be many Not very safe When they came out in the 1970s, they were better than they are now.

Another limitation is that they are not meant to last forever.Different brands have different shelf life, but all IUDs should be replaced or removed After some numbers year.For the copper IUD with the longest replacement time, the user is still Suggest arrive Take it out after 10 to 12 years. Unfortunately, the woman in this case study, Publish In the New England Journal of Medicine On Wednesday, this was not done.

According to reports, the 54-year-old woman went to the emergency room after experiencing symptoms for a while.She has had fever and weight loss for two months, and abdominal pain and walking difficulties for three weeks. During the examination, the doctor noticed a tender lump in her left lower abdomen, and the blood test showed an elevated white blood cell count, which is a common sign of infection. When this woman performed a CT scan of the affected area, the doctor found an intrauterine contraceptive device and multiple abscesses (dead tissue bags filled with pus, white blood cells, And bacteria that are signs of infection) The entire pelvis extends to her left hip joint.The doctor is flow away this Abscess and flushing out Fluid in her buttocks to clear the infection as much as possible.They removed At the same time place the intrauterine contraceptive device.

Long embedding device is coated with unique “sulphur color” particles Often associated With a group of rod-shaped bacteria called actinomycetes (the particles are spherical clumps of bacteria with pus).Sure enough, when they tested the woman’s liquid sample, they were able to isolate the bacteria Actinomycetes israel. This infection is called actinomycosis.

although A. Israel It is a common and usually harmless passerby in the vagina, colon and oral cavity, occasionally causing opportunistic infections.Study author Noriko Arakaki told Gizmodo in an email that IUDs may indeed have played a role in women’s ordeal because these infections are related to the length of time the IUD has been placed (not to mention that the device is Covered by bacteria). In this case, the female IUD is plastic and should be replaced after five years at most, and it is also recommended to check it once a year.Although the author did not ask why the lady chose not to replace it as expected, Arakaki pointed out She is I don’t like hospitals.

“Pelvic actinomycosis occurs in more than 85% of cases after using IUDs for more than 3 years, and it is more common among users who use plastic IUDs than those who use copper IUDs,” Arakaki said. “We believe that the long-term use of IUDs is a factor in this situation.”

The woman then received a long period of intravenous antibiotic treatment, followed by oral antibiotics. Arakaki said that although she is still taking oral antibiotics, she “is in good general health with no recurrence of abscesses and no major complications.”

The authors hope their research will remind others Doctors consider the possibility of actinomycosis in similar cases of pelvic abscess and investigate the patient’s history of IUD. “Secondly, it is important for patients to understand that the IUD must be used correctly, regular outpatient visits are necessary, and must be replaced at the appropriate time,” she added.

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