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An IUD Left in for Way Too Long

The left image is a CT scan taken of the patient, with the arrow pointing to her IUD and the asterisk denoting an nearby abscess. The right image is of the IUD after removal, with the yellow substance thought to be the bacteria that caused her infection.
The left image is a CT scan taken of the patient, with the arrow pointing to her IUD and the asterisk denoting an nearby abscess. The right image is of the IUD after removal, with the yellow substance thought to be the bacteria that caused her infection. Photo: Noriko Arakaki and Yusuke Oshiro/NEJM

Doctors in Japan recently described a serious infection that was likely caused by an intrauterine device left inside a woman’s body for 20 years. The woman visited the ER after months of experiencing fever, weight loss, and eventually abdominal pain and difficulty walking. Tests soon confirmed an infection throughout her pelvis that extended out to her left hip joint. Right in the middle of the grisly action was the woman’s IUD, seemingly surrounded by pockets of pus and bacteria. When the doctors drained her abscesses, they removed the IUD. Once they did, they saw clear as day that it was coated in a gold-colored growth that’s associated with rod-shaped bacteria known as actinomyces. Sure enough, the same bacteria was found in fluid samples from the woman’s infection.

Certain types of IUDs can safely stay in the body for as long as 12 years. But the woman’s plastic, non-hormonal device should have been removed after five years at the latest, and doctors should have been keeping an eye on it at least annually. It’s not certain why the woman kept the IUD as long as she did, though she did admit to not liking hospitals.

Fortunately, the doctors were able to treat her infection successfully, with no major complications afterward.

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