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Obstetrics and Gynecology Aug 2010Pelvic inflammatory disease (PID) is an infection-caused inflammatory continuum from the cervix to the peritoneal cavity. Most importantly, it is associated with...
Pelvic inflammatory disease (PID) is an infection-caused inflammatory continuum from the cervix to the peritoneal cavity. Most importantly, it is associated with fallopian tube inflammation, which can lead to infertility, ectopic pregnancy, and chronic pelvic pain. The microbial etiology is linked to sexually transmitted microorganisms, including Chlamydia trachomatis, Neisseria gonorrheae, Mycoplasma genitalium, and bacterial vaginosis-associated microorganisms, predominantly anaerobes. Pelvic pain and fever are commonly absent in women with confirmed PID. Clinicians should consider milder symptoms such as abnormal vaginal discharge, metrorrhagia, postcoital bleeding, and urinary frequency as potential symptoms associated with the disease, particularly in women at risk of sexually transmitted infection. The diagnosis of PID is based on the findings of lower genital tract inflammation associated with pelvic organ tenderness. The outpatient treatment of mild-to-moderate PID should include tolerated antibiotic regimens with activity against the commonly isolated microorganisms associated with PID and usually consists of an extended spectrum cephalosporin in conjunction with either doxycycline or azithromycin. Clinically severe PID should prompt hospitalization and imaging to rule out a tuboovarian abscess. Parenteral broad-spectrum antibiotic therapy with activity against a polymicrobial flora, particularly gram-negative aerobes and anaerobes, should be implemented. Screening for and treatment of Chlamydia infection can prevent PID.
Topics: Female; Humans; Pelvic Inflammatory Disease
PubMed: 20664404
DOI: 10.1097/AOG.0b013e3181e92c54 -
Adolescent Medicine Clinics Jun 2004Pelvic inflammatory disease (PID) is an infection of the upper female genital tract. It encompasses an array of inflammatory disorders, including endometritis,... (Review)
Review
Pelvic inflammatory disease (PID) is an infection of the upper female genital tract. It encompasses an array of inflammatory disorders, including endometritis, parametritis, salpingitis, oophoritis, tubo-ovarian abscess, peritonitis, and perihepatitis. In most adolescents with acute severe infections it is difficult to differentiate some of these entities; thus the term PID is used commonly. Perihepatitis (Fitz-Hugh-Curtis syndrome) and tubo-ovarian abscess are acute complications, whereas chronic complications include infertility, ectopic pregnancy, and chronic pain.
Topics: Adolescent; Anti-Infective Agents; Diagnosis, Differential; Female; Humans; Pelvic Inflammatory Disease; Risk Factors
PubMed: 15449845
DOI: 10.1016/j.admecli.2004.02.005 -
Clinical Obstetrics and Gynecology Dec 1981Nongonococcal PID remains a major concern in gynecology and an important public health problem. Although debate continues as to the etiologic role of nongonococcal... (Review)
Review
Nongonococcal PID remains a major concern in gynecology and an important public health problem. Although debate continues as to the etiologic role of nongonococcal organisms in acute PID, anaerobic and aerobic bacteria, C. trachomatis, and mycoplasmas have all been implicated. Actinomycotic PID is uniquely related to IUD use. The optimal treatment for nongonococcal PID is unknown, but tetracycline and its derivatives are effective against a broad spectrum of nongonococcal organisms. Abscesses and infertility, in particular, are serious complications of nongonococcal PID. While evolving knowledge about the polymicrobial etiology of acute PID has challenged traditional concepts, continued research should clarify the epidemiology, treatment, and prevention of this important disease.
Topics: Actinomycosis; Aerobiosis; Anaerobiosis; Chlamydia Infections; Chlamydia trachomatis; Female; Humans; Mycoplasma Infections; Pelvic Inflammatory Disease; United States
PubMed: 7037257
DOI: 10.1097/00003081-198112000-00019 -
Current Opinion in Infectious Diseases Feb 2003To review the published literature on pelvic inflammatory disease over the past year and put into context the major findings. (Review)
Review
PURPOSE OF REVIEW
To review the published literature on pelvic inflammatory disease over the past year and put into context the major findings.
RECENT FINDINGS
remains the commonest identified cause of pelvic inflammatory disease, and yet our understanding of how it causes mucosal damage and the factors explaining why only a subgroup of women develop pelvic inflammatory disease are not known. The increasing evidence for a chlamydial toxin may help to explain how tissue damage occurs and the indolent nature of many chlamydial infections. The evidence for as an important sexually transmitted cause of pelvic inflammatory disease is growing, with implications for treatment regimens and diagnostic testing. Power Doppler ultrasound has been reported to be both sensitive and specific in diagnosing pelvic inflammatory disease, although larger studies are needed to confirm these early results. Outpatient treatment with cefoxitin and doxycycline appears to be as effective when given in an outpatient setting compared with inpatient management with the same agents in a large randomized controlled trial with almost 3 years' follow-up.
SUMMARY
There remain many gaps in our knowledge of pelvic inflammatory disease, but the reviewed studies increase our understanding of the pathogenesis of infection, and offer the possibility of better diagnosis and reassurance about the long-term success of antibiotic treatment.
Topics: Centers for Disease Control and Prevention, U.S.; Chlamydia trachomatis; Female; Follow-Up Studies; Humans; Mycoplasma; Pelvic Inflammatory Disease; Practice Guidelines as Topic; Therapeutic Irrigation; United States
PubMed: 12821828
DOI: 10.1097/00001432-200302000-00007 -
Annals of Epidemiology Mar 1994Most pelvic inflammatory disease (PID) is caused by the ascent of sexually transmitted disease pathogens from the endocervix. In fact, PID remains the most common... (Review)
Review
Most pelvic inflammatory disease (PID) is caused by the ascent of sexually transmitted disease pathogens from the endocervix. In fact, PID remains the most common serious complication of infection from sexually transmitted bacterial pathogens. PID also may be caused by normal vaginal micro-organisms (such as those associated with bacterial vaginosis) that have overgrown in the vagina. PID has been linked to the occurrence of long-term sequelae, most commonly and most importantly infertility and ectopic pregnancy. In many patients PID may remain undiagnosed and asymptomatic, and may not become evident until such long-term consequences become manifest. We briefly review the epidemiology of PID including case definitions, the prevalence of the problem, and causal pathways and associated risk factors. Risk factors for both PID and its sequelae are discussed in relation to the mechanism of ascent of associated etiologic agents from the lower to the upper genital tract.
Topics: Female; Humans; Pelvic Inflammatory Disease
PubMed: 8205279
DOI: 10.1016/1047-2797(94)90058-2 -
Australian Family Physician May 2003Pelvic inflammatory disease (PID) is a treatable condition with serious long term sequelae. Due to the wide spectrum of disease and clinical presentation, diagnosis can... (Review)
Review
BACKGROUND
Pelvic inflammatory disease (PID) is a treatable condition with serious long term sequelae. Due to the wide spectrum of disease and clinical presentation, diagnosis can often be challenging.
OBJECTIVE
This article discusses the diagnosis, management and treatment of PID in the general practice setting.
DISCUSSION
Prompt and effective treatment is essential in cases of PID. A high index of suspicion for symptomatic women at risk may help decrease the burden of serious associated morbidity.
Topics: Female; Humans; Pelvic Inflammatory Disease; Risk Factors
PubMed: 12772359
DOI: No ID Found -
Emergency Radiology Feb 2017Representing an ascending, sexually spread pyogenic infection of the female genital tract, pelvic inflammatory disease (PID) is a commonly encountered cause for... (Review)
Review
Representing an ascending, sexually spread pyogenic infection of the female genital tract, pelvic inflammatory disease (PID) is a commonly encountered cause for emergency visits and hospitalizations among young and adult female patients. Though gynecologic evaluation and sonography constitute the mainstay of diagnosis, multidetector CT imaging of the abdomen and pelvis is not uncommonly performed, often as the initial imaging modality, due to the frequently vague and indeterminate clinical presentation. As such, knowledge and attenuation to the often subtle early imaging features of PID afford the radiologist a critical chance to direct and expedite appropriate pathways of patient care, minimizing the risk for secondary complications, including infertility, ectopic pregnancy, and enteric adhesions. In this paper, we will review the pathophysiology, clinical presentation, early and late imaging features of PID as well as potential secondary complications and treatment options. Additionally, we will discuss published data metrics on CT performance regarding sensitivity and specificity for diagnosis as well as potential imaging differential diagnostic considerations.
Topics: Female; Humans; Multidetector Computed Tomography; Pelvic Inflammatory Disease; Sensitivity and Specificity
PubMed: 27646971
DOI: 10.1007/s10140-016-1444-8 -
Clinical Evidence Jun 2006
Review
Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Female; Humans; Pelvic Inflammatory Disease
PubMed: 16973083
DOI: No ID Found -
American Family Physician Apr 2012
Topics: Anti-Bacterial Agents; Chlamydia Infections; Female; Gonorrhea; Humans; Pelvic Inflammatory Disease
PubMed: 22534389
DOI: No ID Found -
Sexually Transmitted Infections Apr 2000
Review
Topics: Adolescent; Adult; Age Distribution; Cost of Illness; Female; Forecasting; Humans; Incidence; Pelvic Inflammatory Disease; Prevalence; Research; Risk Factors; United Kingdom
PubMed: 10858707
DOI: 10.1136/sti.76.2.80