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.

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.

Keywords:

• Actinomyces
• intrauterine device

Disclosure statement/Funding

The planners and faculty for this activity have no relevant financial relationships or funding to disclose. The patient consented to publication of this case report.