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Re: actinomycosis in IUDFrom: RModugno@aol.comMon Oct 20 20:54:14 2003
In a message dated 10/20/2003 6:53:19 PM Eastern Standard Time, rchudacoff@mylinuxisp.com writes: Replaced a copper T IUD with a Mirena progesterone intrauterine system IUD last week and today I received a call from the pathologist that the copper IUD was ‘ as covered with actinomyces’ as he had ever seen. Needless to say, the Mirena comes out as soon as I can get a hold of her, but do I still need to treat her for 6-12 months in an asymptomatic infection? Do I need to scope her to rule out PID if there is no pain? She really expressed the desire for permanent infertility, even though she is a 27 year old nullipara. I should say that she is not entirely asymptomatic. I replaced the IUD with the IUS because of dysmenorrhea and menorrhagia. There is no dyspareunia, nor tenderness on bimanual exam. Call me crazy, but I'm not 100% sure you need to remove the new IUD.Laparoscopy certainly is not indicated.You may want to treat her prophylactically eith antibiotics, or repeat a smear/culture in 6weeks. My 2 cents. Robert Modugno MD MBA FACOG marietta, GA http://www.novaobgyn.yourmd.com
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