Abstract
Background : The severe adverse effects of intra-uterine contraceptive devices (IUDs) can include pelvic inflammatory disease caused by Actinomyces israelii, the pre-treatment diagnosis of which is extremely difficult. Almost all diagnoses have been made based on the post-operative pathological examination. Nevertheless, some reports describe the possibility of a pre-operative diagnosis using cytology or culture. Cytology might be superior to culture examination for diagnosis because it enables a convenient and rapid diagnosis.
Case : A 46-year-old gradiva 2 para 2 female was admitted for lower abdominal pain with fever. She had used the same IUD for 10 years. We removed the IUD and treated her with antibiotics. After 40 days, she presented with lower abdominal pain. Magnetic resonance imaging revealed a large abscess in the pelvic cavity. Laparotomy showed a swollen right adnexal lesion, which resembled actinomycosis. Review of the stamp cytology taken from the IUD confirmed actinomycosis.
Conclusion : This case suggests that cytology using stamp preparation from an IUD might be useful for the pretreatment diagnosis of actinomycosis.
