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Diagnosis of Pelvic Inflammatory Disease

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Abstract

Pelvic inflammatory disease (PID) is difficult to diagnose. Symptoms and signs associated with PID are common for different diseases and vary from case to case. Without invasive procedures, the organs of interest are invisible and indirectly palpable. The result is that we sometimes misdiagnose PID in healthy women (overdiagnosis). Sometimes we think women with acute PID are healthy (underdiagnosis), and sometimes we diagnose PID in women who have other diseases (misdiagnosis). Overdiagnosis may lead to inappropriate hospital care, antibiotic treatment, and surgery. Underdiagnosis may lead to delayed antibiotic treatment with increased risk for complications, including tubo-ovarian abscess, infertility, and later, ectopic pregnancy. Misdiagnosis may result in delay of appropriate treatment of other diseases, including appendicitis and ectopic pregnancy.

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References

  1. Bongard F, Landers D, Lewis F. Differential diagnosis of appendicitis and pelvic inflammatory disease. Am J Surg 1985;150:90–96.

    Article  PubMed  CAS  Google Scholar 

  2. Weström L. Diagnosis, Aetiology, and Prognosis of Acute Salpingitis, thesis. Studentlitteratur, Lund, Sweden, 1976.

    Google Scholar 

  3. Kahn JG, Walker CK, Washington E, et al. Diagnosing pelvic inflammatory disease. A comprehensive analysis and considerations for developing a new model. JAMA 1991;266:2594–2604.

    Article  PubMed  CAS  Google Scholar 

  4. Wølner-Hanssen P, Mårdh P-A, Svensson L, et al. Laparoscopy in women with chlamydial infection and pelvic pain: A comparison of patients with and without salpingitis. Obstet Gynecol 1983;61:299–303.

    PubMed  Google Scholar 

  5. Hadgu A, Weström L, Brooks CA, et al. Predicting pelvic inflammatory disease: A multivariate analysis. Am J Obstet Gynecol 1986;155:954–960.

    PubMed  CAS  Google Scholar 

  6. Tavelli BG, Judson FN. Comparison of the clinical and epidemiologic characteristics of gonococcal and nongonococcal pelvic inflammatory disease seen in a clinic for sexually transmitted diseases, 1978-1979. Sex Transm Dis 1986;13: 119–122.

    Article  PubMed  CAS  Google Scholar 

  7. Wølner-Hanssen P, Eschenbach DA, Paavonen J, et al. Decreased risk of chlamydial pelvic inflammatory disease associated with oral contraceptive use. JAMA 1990;263:54–59.

    Article  PubMed  Google Scholar 

  8. Wølner-Hanssen P, Svensson L, Mârdh P-A, Weström L. Laparoscopic findings and contraceptive use in women with signs and symptoms suggestive of acute salpingitis. Obstet Gynecol 1985;66:233–238.

    PubMed  Google Scholar 

  9. Svensson L, Weström L, Mârdh P-A. Contraceptives and acute salpingitis. JAMA 1984;251:2553–2555.

    Article  PubMed  CAS  Google Scholar 

  10. Wølner-Hanssen P. Oral contraceptive use modifies the manifestations of pelvic inflammatory disease. Br J Obstet Gynecol 1986;93:619–624.

    Article  Google Scholar 

  11. Washington AE, Gove S, Schachter J, Sweet RL. Oral contraceptives, Chlamy-dia trachomatis infection, and pelvic inflammatory disease: A word of caution about protection. JAMA 1985;253:2246–2250.

    Article  PubMed  CAS  Google Scholar 

  12. Hajj SN. Does sterilization prevent pelvic infection? J Reprod Med 1978;20:289.

    PubMed  CAS  Google Scholar 

  13. Fletcher V Jr. Proximal stump salpingitis. Am J Obstet Gynecol 1986;155: 496–500.

    PubMed  Google Scholar 

  14. Blanchard AC, Pastorek JG, Weeks T. Pelvic inflammatory disease during pregnancy. South Med J 1987;80:1363–1365.

    Article  PubMed  CAS  Google Scholar 

  15. Lehtinen M, Laine S, Heinonen PK, et al. Serum C-reactive protein determination in acute pelvic inflammatory disease. Am J Obstet Gynecol 1986;154: 158–159.

    PubMed  CAS  Google Scholar 

  16. Hemilä M, Henriksson L, Ylikorkala O. Serum CRP in the diagnosis and treatment of pelvic inflammatory disease. Arch Gynecol Obstet 1987;241: 177–182.

    Article  PubMed  Google Scholar 

  17. Schmidt-Rhode P, Schulz K-D, Sturm G, et al. C-reactive protein is a marker for the diagnosis of adnexitis. Int J Obstet Gynecol 1990;32:133–139.

    Article  CAS  Google Scholar 

  18. Jacobson L, Weström L. Objectivized diagnosis of pelvic inflammatory disease. Am J Obstet Gynecol 1969;105:1088–1098.

    PubMed  CAS  Google Scholar 

  19. Treharne J, Ripa KT, Mârdh P-A, et al. Antibodies to Chlamydia trachomatis in acute salpingitis. Br J Vener Dis 1979,55:26–29.

    PubMed  CAS  Google Scholar 

  20. Moore DE, Spadoni LR, Foy HM, et al. Increased frequency of serum antibodies to Chlamydia trachomatis in infertility due to distal tubal disease. Lancet 1982;ii:574–577.

    Article  Google Scholar 

  21. Osborne NG, Hecht Y, Gorsline J, et al. A comparison of culture, direct fluorescent antibody test, and a quantitative indirect immunoperoxidase assay for detection of Chlamydia trachomatis in pregnant women. Obstet Gynecol 1988;71:412–415.

    PubMed  CAS  Google Scholar 

  22. Brunham RC, Paavonen J, Stevens C, et al. Mucopurulent cervicitis: The ignored counterpart in women of urethritis in men. N Engl J Med 1984;311:1–6.

    Article  PubMed  CAS  Google Scholar 

  23. Willmott FE. Mucopurulent cervicitis: A clinical entity? Genitourin Med 1988;64:169–171.

    PubMed  CAS  Google Scholar 

  24. Moscicki B, Shafer M-A, Millstein SG, et al. The use and limitations of endo-cervical Gram stains and mucopurulent cervicitis as predictors for Chlamydia trachomatis in female adolescents. Am J Obstet Gynecol 1987;157:65–71.

    PubMed  CAS  Google Scholar 

  25. Larsson P-G, Platz-Christensen JJ. Bacterial vaginosis and the vaginal leucocyteJepithelial cell ratio in women attending an outpatient gynaecology clinic. Em J Obstet Gynecol Reprod Biol 1991;38:39–41.

    Article  CAS  Google Scholar 

  26. Paavonen J, Aine R, Teisala K, et al. Comparison of endometrial biopsy and peritoneal fluid cytologic testing with laparoscopy in the diagnosis of acute pelvic inflammatory disease. Am J Obstet Gynecol 1985;151:645–650.

    PubMed  CAS  Google Scholar 

  27. Sweet RL, Mills J, Hadley KW, et al. Use of laparoscopy to determine the microbiologic etiology of acute salpingitis. Am J Obstet Gynecol 1979;134:68–74.

    PubMed  CAS  Google Scholar 

  28. Weström L. Effect of acute pelvic inflammatory disease on fertility. Am J Obstet Gynecol 1975;121:707–713.

    PubMed  Google Scholar 

  29. Miettinen AK, Heinonnen PK, Laippala P, Paavonen J. Test performance of erythrocyte sedimentation rate and C-reactive protein in assessing the severity of acute pelvic inflammatory disease. Am J Obstet Gynecol 1993;169:1143–1149.

    PubMed  CAS  Google Scholar 

  30. Stacey C, Munday P, Thomas B, et al. Chlamydia trachomatis in the fallopian tubes of women without laparoscopic evidence of salpingitis. Lancet 1990; ii:960–963.

    Article  Google Scholar 

  31. Sellors J, Mahony J, Goldsmith C, et al. The accuracy of clinical findings and laparoscopy in pelvic inflammatory disease. Am J Obstet Gynecol 1991;164: 113–120.

    PubMed  CAS  Google Scholar 

  32. Kiviat N, Wølner-Hanssen P, Eschenbach D, et al. Endometrial histopathol-ogy in patients with culture-proven upper genital tract infection and laparoscopically diagnosed acute salpingitis. Am J Surg Pathol 1990;14(2): 167–175.

    Article  PubMed  CAS  Google Scholar 

  33. Cacciatore B, Leminen A, Ingman-Friberg S, et al. Transvaginal sonographic findings in ambulatory patients with suspected pelvic inflammatory disease. Obstet Gynecol 1992;80:912–916.

    PubMed  CAS  Google Scholar 

  34. Patten RM, Vincent LM, Wølner-Hanssen P, et al. Pelvic inflammatory disease: Endovaginal sonography with laparoscopic correlation. J Ultrasound Med 1990;9:681–689.

    PubMed  CAS  Google Scholar 

  35. Puylaert JBCM, Rutgers PH, Lalisang RI, et al. A prospecitve study of ultrasonography in the diagnosis of appendicitis. N Engl J Med 1987;317: 666–669.

    Article  PubMed  CAS  Google Scholar 

  36. Weström L. Clinical manifestations and diagnosis of pelvic inflammatory disease. J Reprod Med 1983;28(suppl):703–708.

    PubMed  Google Scholar 

  37. Hager WD, Eschenbach DA, Spence MR, Sweet RL. Criteria for diagnosis and grading of salpingitis. Obstet Gynecol 1983;61:113–114.

    PubMed  CAS  Google Scholar 

  38. Punnonen R, Terho P, Nikkanen V, et al. Chlamydial serology in infertile women by immunofluorescence. Fertil Steril 1979;31:656–659.

    PubMed  CAS  Google Scholar 

  39. Wølner-Hanssen P. Silent pelvic inflammatory disease: Is it overstated? Obstet Gynecol 1995;86:321–325.

    Article  PubMed  Google Scholar 

  40. Wølner-Hanssen P, Kiviat NK, Holmes KK. Atypical pelvic inflammatory disease: Subacute, chronic, or subclinical upper genital tract infection in women. In Holmes KK, Mårdh P-A, Sparling PF, Wiesner PJ (eds): Sexually Transmitted Diseases. 2nd ed. New York, McGraw-Hill Book Company, 1989, pp 615–620.

    Google Scholar 

  41. Paavonen J, Kiviat N, Brunham R, et al. Prevalence and manifestations of endometritis among women with cervicitis. Am J Obstet Gynecol 1985;152: 280–286.

    PubMed  CAS  Google Scholar 

  42. Hillis SD, Joesoef R, Marchbanks PA, et al. Delayed care of pelvic inflammatory disease as a risk factor for impaired fertility. Am J Obstet Gynecol 1993;168:1503–1509.

    PubMed  CAS  Google Scholar 

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© 1997 Springer Science+Business Media New York

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Wølner-Hanssen, P. (1997). Diagnosis of Pelvic Inflammatory Disease. In: Landers, D.V., Sweet, R.L. (eds) Pelvic Inflammatory Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-0671-2_4

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  • DOI: https://doi.org/10.1007/978-1-4612-0671-2_4

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-6863-5

  • Online ISBN: 978-1-4612-0671-2

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