A woman with IUCD develops pelvic inflammatory disease. Which of the following should be done?
PID occurs usually within 4 weeks of inseion and may be due to existing unrecognized vaginal infection, or the tail of IUCD causing ascending infection. Occurrence of PID per se is not an indication of IUCD removal as there could be other causes of occurrence of PID which is usually manageable with antibiotics. It is in fact rare for PID to have occurred secondary to IUCD inseion since sterile practices are followed. Pelvic inflammatory disease (PID) without abscess is treated initially with systemic antibiotics and followed up for response. Actinomycosis is an infection commonly associated with IUCD. if signs or symptoms of infection develop in women who harbour Actinomyces species, then the device should be removed and antimicrobial therapy instituted. Actinomyces species are sensitive to antimicrobials with gram-positive coverage, notably the penicillins.
Keep the IUCD, give antibiotic, follow up for antibiotic response and then take decision regarding IUCD removal
Sta antibiotics and then remove IUCD
Remove IUCD and then sta antibiotics
Wait till next menstrual cycle for any intervention
Genital Tract Infections (Too hot to handle!)