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TSS Syndrome From the Mirena IUD

An intrauterine device is a small object inserted into a woman's vagina by a doctor or nurse practitioner to prevent pregnancy. The Mirena is a plastic IUD that contains progesterone. Pelvic infections can occur with IUDs, but toxic shock syndrome associated with IUD insertion is extremely rare.

  1. Toxic Shock Syndrome

    • TSS is caused by Staphylococcus and Streptococcus bacteria. The syndrome is most commonly associated with tampon use, but it can be caused by other factors that introduce these bacteria into the bloodstream.

    TSS Symptoms

    • TSS has symptoms of abdominal pain, nausea, vomiting and high fever. It can rapidly progress to abnormally low blood pressure leading to shock and death.

    Considerations

    • A study published in a 2009 issue of the European Journal of Contraceptive and Reproductive Health Care states that although infections caused by IUD insertion are uncommon, TSS should be considered if fever and shock occur soon after an IUD is inserted.

    Severe Effects

    • The woman in the European case survived, but needed an emergency total hysterectomy and removal of both fallopian tubes. This was the first reported case of group A Streptococcal bacteria causing TSS associated with IUD insertion. The case involved a copper IUD.

    One Fatality

    • A study published in the Annals of Emergency Medicine in 2009 discusses the first-known case of fatal toxic shock syndrome related to an IUD. This case was caused by Staphylococcus bacteria.

    Contraindications

    • Women who have ever had TSS should not have an IUD inserted because these women have increased risk of another TSS episode.

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