Pelvic Inflammatory Disease Flashcards
(5 cards)
What is Pelvic Inflammatory Disease (PID)
- Inflammation of the upper genital tract due to an infection in women - can be caused by a variery of things
- Tends to be related to sexually transmitted infections; commonly involved are Neisseria gonorrhoea, and Chlamydia trachomatis.
- Inflammation can lead to inflammatory damage, scarring, adhesions - affecting fertility, and increased risk for ectopic pregnancy. Can also lead to chronic pain.
- PID as it is serious, should be suspected in those that are sexually active, presenting with lower abdominal or pelvic pain and genital tract tenderness, and referral is necessary, as
urgent treatment is required.
What are the signs and symptoms of PID?
- Lower abdominal pain, unilateral or bilateral
- Mucopurulent cervical discharge
- Abnormal uterine bleeding, particularly during or after menses.
- Dyspareunia - painful sex
- Dysuria
- Cervical motion tenderness
- Sometimes there can be fever, anorexia, nausea, vomiting
Many do not have symptoms at all
Complications
* Tubo-ovarian or pelvic abscess - you may be able to feel tho can be very tender
* Hydrosalpinx - tubal distension
* Chronic pelvic pain
* Infertility
* Ectopic pregnancy
* Fitz-Hugh-Curtis syndrome (perihepatitis) - spread of the inflammation, and inflammation of the capsule of the liver
What are common DDx?
DDX
* Endometriosis
* Ovarian cyst rupture
* Appendicitis
* Ectopic pregnancy
* Ovarian torsion
* Cystitis
* Diverticulitis
* Traumatic injury
* Pyelonephritis - kidney infection
What are triggers or risk factors?
Risk factors
* Previous PID
* Bacterial vaginosis or any sexually transmitted infection
* Most frequently in ages 15 to 25 years
* Multiple or new sex partners
* Condom use is protective
* Douching
What is conventional diagnosis and treatment?
Diagnosis
* Laboratory tests, ultrasound or CT can be inconclusive, no negative results do not exclude diagnosis
* Pregnancy test to rule out ectopic pregnancy
* Laparoscopy; purulent peritoneal material noted
Treatment: Antibiotics as soon as it is suspected. Partners should be treated.
STIs must be referred
