Pelvic Inflammatory Diseases

The diagnosis and management of pelvic inflammatory disease (PID) is based upon clinical signs and symptoms. PID encompasses infections of the uterus (endometritis or myometritis), fallopian tubes (salpingitis), ovaries (oophoritis), broad ligaments (parametritis), and pelvic peritoneum (peritonitis). PID affects up to one million women each year in the United States and is the number one reason for hospital admissions among women of reproductive age. PID is a polymicrobial disorder that results from ascending infection of bacterial flora from the vagina and cervix. The two initiating pathogens include Neisseria gonorrhoeae and Chlamydia trachomatis. PID initiated by N. gonorrhoeae tends to be more acute and severe than that caused by C. trachomatis. Risk factors for PID include young age, history of multiple sexual partners, and a history of sexually transmitted diseases. Patients with PID commonly present with acute or subacute diffuse abdominopelvic pain and fever during or after their menses. Additional clinical criteria for PID include cervical motion or adnexal tenderness, and cervical or vaginal discharge.