Pelvic inflammatory disease Flashcards
(12 cards)
What is PID?
Inflammation & infection of the organs of the pelvis (including the uterus, fallopian tubes, ovaries and surrounding peritoneum) caused by infection spreading up through the cervix
Causes of PID?
Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium
What are some non-STI causes of PID?
Gardnerella vaginalis, Haemophilus influenza, E. coli
Risk factors for PID?
Younger person with current STIs who have multiple sexual partners & don’t use barrier contraception, IUD
Presentation of PID?
Pelvic or lower abdominal pain, Abnormal vaginal discharge, Abnormal bleeding, Dyspareunia, Fever, Dysuria
Examination findings in PID?
- Pelvic tenderness
- Cervical motion tenderness, Inflamed cervix
- Purulent discharge
- May have fever and other signs of sepsis
Tests for PID?
NAAT swabs for gonorrhoea & chlamydia, NAAT swabs for Mycoplasma genitalium, HIV & syphilis test
Other investigations for PID?
- High vaginal swab to look for bacterial vaginosis, candidiasis & trichomoniasis, - Microscope for pus cells on swabs from vagina or endocervix - absence of pus is useful for excluding PID
- Pregnancy test to exclude ectopic pregnancy, Inflammatory markers will be raised
Management of PID?
GUM clinic, Antibiotics to cover each infection
- first line: stat IM ceftriaxone + 14 days of oral doxycycline + oral metronidazole
- second line: oral ofloxacin + oral metronidazole
Complications of PID?
Sepsis, Abscess, Infertility, Chronic pelvic pain, Ectopic pregnancy, Fitz-Hugh-Curtis syndrome
What is Fitz-Hugh-Curtis syndrome?
A complication of PID caused by inflammation & infection of the liver capsule (Glisson’s capsule) which leads to adhesions between liver & peritoneum
What does Fitz-Hugh-Curtis syndrome result in?
Right upper quadrant pain referred to right shoulder tip if diaphragmatic irritation, Laparoscopy can be used to visualise and treat adhesions by adhesiolysis
