Spontaneous Conception Despite a Long-Standing Vaginal Foreign Body Colonised by E. coli: A Rare Case Report
Naina Kumar, Mishu Mangla, Annapurna Srirambhatla, Subhrajyoti Roy, Pooja Rathod, Jarathi AparnaIntroduction:
Retained vaginal foreign bodies are an uncommon but important cause of genital tract symptoms, often associated with infection, discharge, or infertility. However, their coexistence with spontaneous conception is exceedingly rare.
Case Presentation:
A 20-year-old woman (P0L0A1), married for two years, presented with persistent lower abdominal pain and dyspareunia. She denied any history of sexual assault or abuse. With gentle and empathetic questioning, she eventually revealed that she had inserted a small plastic torch into her vagina about five years earlier; the device had broken, and a fragment had remained inside. Notably, despite the prolonged presence of the foreign body and associated infection, the patient had achieved spontaneous conception. Pelvic examination showed a large, impacted foreign body lodged high in the left vaginal fornix and encased in dense fibrotic tissue. Transvaginal ultrasonography and magnetic resonance imaging confirmed its presence and precise location. Under anaesthesia, a high vaginal foreign body was palpated and removed via a transverse stab incision in the left vaginal fornix after ensuring bladder and rectal safety. Thick purulent material surrounded the object, and culture grew Escherichia coli. She received broad-spectrum antibiotics postoperatively, and a vaginal mould was placed to reduce the risk of stenosis. The patient showed clinical improvement thereafter. Retained foreign bodies can act as a nidus for microbial colonisation and chronic inflammation, potentially leading to reproductive morbidity. In this case, the presence of a foreign body in conjunction with infection suggests a possible association; however, a definitive causal relationship cannot be established due to the absence of longitudinal microbiological and inflammatory data. The occurrence of spontaneous conception despite these factors highlights the variable impact of such conditions on fertility and may contribute to delayed clinical suspicion.
Conclusion:
This case underscores the importance of considering a retained vaginal foreign body in patients with persistent or unexplained genital tract symptoms, even in those who have achieved conception. Early recognition and removal are essential to prevent ongoing morbidity