Pelvic Inflammatory Disease Flashcards
(14 cards)
What is pelvic inflammatory disease?
Inflammation + infection of the female pelvic organs incl. uterus, fallopian tubes, ovaries + surrounding peritoneum
Due to ascending infection from Endocervix
What is endometritis?
Inflammation of endometrium
What is salpingitis?
Inflammation of fallopian tubes
What is oophoritis?
Inflammation of ovaries
What is parametritis?
Inflammation of parametrium - connective tissue wound the uterus
Causes of PID
Most commonly STIs;
- chlamydia trachomatis (most common)
- neisseria gonorrhoeae (more severe PID)
- mycoplasma genitalium
.
Less commonly non-STIs:
- gardnerella vaginalis
- Haemophilus influenzae
- e.coli
Risk factors of PID
- non using barrier contraception
- younger age
- multiple sexual partners
- existing STIs
- previous PID
- copper coil
Presentation of PID
- pelvic or lower abdominal pain
- abnormal vaginal discharge
- inter menstrual or postcoital bleeding
- dysuria
- dyspareunia
- fever
- RUQ pain due to peri-hepatitis
Examination findings of PID
- pelvic tenderness
- cervicitis
- purulent discharge
- cervical motion tenderness (cervical excitation)
Investigations of PID
- pregnancy test
- high vaginal swab for non STI causes
- NAAT for chlamydia, gonorrhoea + mycoplasma genitalium test
- HIV test
- syphilis test
- inflammatory markers
Management of PID
- first line: stat IM Cefriaxone + 14 days oral doxycycline + metronidazole
- second line: oral ofloxacin + metronidazole
What do high vaginal swabs test for?
BV - gardnerella vaginalis
Candidiasis - Candida albicans
Trichomoniasis - trichomonas vaginalis
Complications of PID
- sepsis
- abscess
- infertility
- chronic pelvic pain
- ectopic pregnancy
- fitz-hugh-Curtis syndrome
Outline Fitz-Hugh-Curtis syndrome
- complication of PID
- caused by inflammation + infection of liver (Glisson’s) capsule > adhesions between liver + peritoneum
- RUQ pain that can refer to right shoulder
