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November 14, 1977

Group A Streptococcal Sepsis and ArthritisOrigin From an Intrauterine Device

JAMA. 1977;238(20):2178. doi:10.1001/jama.1977.03280210070030

INFECTION is a recognized risk of the intrauterine device (IUD).1 The causative organisms are usually vaginal or colonic flora or Neisseria gonorrhoeae, and the infections tend to be localized to the pelvis.2 We report a case of group A streptococcal septicemia with monoarticular arthritis, originating from an infected IUD. Our evidence suggests that the infection was transmitted to the patient through sexual foreplay.

Report of a Case  A 28-year-old woman had fever and chills followed by headache, nausea, and vomiting. After three days she was awakened at night by severe pain in her right shoulder and wrist. During the next two days, this pain became worse and she sought medical attention.Her past medical history was unremarkable. A Lippe's loop was inserted two years earlier following her second normal pregnancy and delivery.Three weeks before her present illness, sore throat and cellulitis of several fingers on both hands