Medical Must-See: Forgotten IUD delivers painful reminder
The patient was as surprised as the ED doctor about the cause of her infection
An interesting yarn in BMJ Case Reports tells of a woman who developed a rare pelvic actinomycosis commonly associated with IUDs — only, according to the patient, she had never had one.
The woman, in her 60s, presented to ED with a painful abdominal mass in the right lower quadrant. She also reported asthenia, weight loss and anorexia and had a history of cardiovascular risk factors and acute MI.
Doctors noted a tubular swelling with an elastic consistency and regular contours, measuring 20cm × 10 cm. Pain was elicited on palpation, but there were no inflammatory signs.
An FBC was significant for anaemia (10.3g/dL), leukocytosis (20.25 × 103/µL) and elevated CRP (263.6mg/L) and negative tumour markers.
