PID

Question 1

What are some of the risk factors?

Answer 1

Gender, prior infection, existing STI, multiple partners

Question 2

What are some of the complications?

Answer 2

Infertility, recurrent infections, ectopic pregnancy

Question 3

What investigations would you perform if suspecting gonorrhoea?

Answer 3

NAAT of first catch urine and/or endocervical swab, culture on chocolate blood agar/VCN. Rest is the usual ancillary tests, transvaginal and transabdominal ultrasound, urinalysis. DON’T FORGET beta-HCG!

Question 4

What are the common causative agents?

Answer 4

Often polymicrobial - Neisseria gonorrhoea, chlamydia trichomatis, Mycoplasma genitalium, E. coli

Question 5

How would you pharmacologically manage the patient?

Answer 5

Mild/moedrate = Ceftriaxone + metronidazole + doxycycline.
Severe = Ceftriaxone + metronidazole + azithromycin

Question 6

What should you counsel the patient on?

Answer 6

Avoid sex for at least 7 days following treatment. Also, contact tracing is important. Review on day 3 for response to treatment, as well as 2 weeks later for recovery and progress of contact tracing. Also counsel on contraception and safe sex practices.