Pelvic Inflammatory Disease
Anh Do
Introduction
Inflammatory disorders of upper genital tract:
Endometritis
Salpingitis
Oophoritis
Tubo-ovarian abscess
Pelvic peritonitis
Broad spectrum of clinical presentation
Highest rate of PID in adolescents 15-19 years
Etiology
Gonorrhea
Chlamydia
Anaerobes
Enteric Gram-negative bacilli
Mycoplasma
Ureaplasma
Risk Factors
Young age
Multiple sexual partners
Sexually transmitted infection (gonorrhea, chlamydia)
Nonuse of barrier methods
Prior history of pelvic inflammatory disease
Intrauterine device
Possible risk factors: douching, low socioeconomic status
Clinical Presentation
May be asymptomatic to severe
Symptoms include:
Malodorous discharge, dyspareunia, irregular vaginal bleeding, dysuria, nausea, vomiting, fever
Exam
Lower abdominal tenderness, peritoneal signs
Pelvic exam:
Cervical, vaginal discharge
Uterine tenderness, adnexal tenderness, cervical motion tenderness
