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Infectious Diseases in Obstetrics and... 2011Pelvic inflammatory disease (PID), one of the most common infections in nonpregnant women of reproductive age, remains an important public health problem. It is... (Review)
Review
Pelvic inflammatory disease (PID), one of the most common infections in nonpregnant women of reproductive age, remains an important public health problem. It is associated with major long-term sequelae, including tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. In addition, treatment of acute PID and its complications incurs substantial health care costs. Prevention of these long-term sequelae is dependent upon development of treatment strategies based on knowledge of the microbiologic etiology of acute PID. It is well accepted that acute PID is a polymicrobic infection. The sexually transmitted organisms, Neisseria gonorrhoeae and Chlamydia trachomatis, are present in many cases, and microorganisms comprising the endogenous vaginal and cervical flora are frequently associated with PID. This includes anaerobic and facultative bacteria, similar to those associated with bacterial vaginosis. Genital tract mycoplasmas, most importantly Mycoplasma genitalium, have recently also been implicated as a cause of acute PID. As a consequence, treatment regimens for acute PID should provide broad spectrum coverage that is effective against these microorganisms.
Topics: Acute Disease; Adult; Anti-Bacterial Agents; Female; Humans; Pelvic Inflammatory Disease
PubMed: 22228985
DOI: 10.1155/2011/561909 -
The Journal of the American Board of... 1994Acute pelvic inflammatory disease (PID) is a major gynecologic health problem in the United States, afflicting more than 1 million women each year and generating annual... (Review)
Review
BACKGROUND
Acute pelvic inflammatory disease (PID) is a major gynecologic health problem in the United States, afflicting more than 1 million women each year and generating annual direct and indirect costs estimated at $4.2 billion. Family physicians can play an important role in the prevention, as well as diagnosis and treatment, of PID.
METHODS
A MEDLINE search for articles published from 1985 to the present was made using the key words "pelvic inflammatory disease," "endometritis," "salpingitis," "tubo-ovarian abscess," "adnexitis," "pelvic abscess," "parametritis," and "oophoritis." The bibliographies of these articles and the author's personal files were also sources of information.
RESULTS AND CONCLUSIONS
A number of risk factors have been linked to PID, including young age, age at first intercourse, multiple sex partners, the presence of bacterial vaginosis, vaginal douching, the use of an intrauterine contraceptive device, and a history of a sexually transmitted disease. The diagnosis of PID represents a major clinical challenge that requires a careful history and physical examination coupled with selective and knowledgeable use of the diagnostic tests and procedures currently available. Broad-spectrum antibiotics, which represent the cornerstone of therapy, must adequately cover the polymicrobial spectrum of pathogens implicated in this infection, which includes Neisseria gonorrhoeae, Chlamydia trachomatis, and specific cervicovaginal anaerobic and aerobic bacteria. The numerous sequelae associated with PID, which include infertility, ectopic pregnancy, and chronic pelvic pain syndromes, underscore the need for effective measures for preventing pelvic inflammatory disease.
Topics: Acute Disease; Adolescent; Adult; Age Factors; Anti-Bacterial Agents; Diagnosis, Differential; Female; Humans; Incidence; Pelvic Inflammatory Disease; Risk Factors; Sexually Transmitted Diseases
PubMed: 8184701
DOI: No ID Found -
AIDS Patient Care and STDs Feb 1998Over one million women experience an episode of pelvic inflammatory disease (PID) each year. It is the most common serious complication of STDs; long-term sequelae... (Review)
Review
Over one million women experience an episode of pelvic inflammatory disease (PID) each year. It is the most common serious complication of STDs; long-term sequelae include ectopic pregnancy, chronic pelvic pain, and tubal infertility. One in five cases of PID occurs among younger women < 19 years of age. Although only about half of female adolescents are sexually active, they have the highest age-specific rates of PID among sexually experienced women. The risk of developing PID for a 15-year-old sexually active girl is estimated to be 10 times that of a 24-year-old woman. The higher relative risk of PID for younger women has been attributed to their greater biologic vulnerability and their behavioral and cognitive risk factors. In addition, HIV-infected women with PID may be at increased risk for more severe pelvic disease, a growing concern as rates of HIV infection among adolescent girls continue to rise. This article reviews the epidemiology, risk factors, pathogenesis, clinical assessment, and management of PID in adolescent females, including age-specific information when available.
Topics: Adolescent; Adult; Age Distribution; Anti-Bacterial Agents; Female; Humans; Incidence; Pelvic Inflammatory Disease; Pregnancy; Prognosis; Risk Factors; Sexually Transmitted Diseases
PubMed: 11361905
DOI: 10.1089/apc.1998.12.109 -
Critical Care Nursing Clinics of North... Mar 2003Pelvic inflammatory disease affects approximately 1 million women per year in the United States alone and has a variety of causative organisms. Because the diagnosis of... (Review)
Review
Pelvic inflammatory disease affects approximately 1 million women per year in the United States alone and has a variety of causative organisms. Because the diagnosis of PID is based on clinical judgment, health care providers need to be guided by the CDC recommendations for diagnosing and treating PID. Because presenting symptoms are often vague, the health care provider should assess female patients for risky behaviors that may lead to PID and should use screening data when making clinical judgments and differential diagnoses. Whenever possible, female patients with PID should be treated as outpatients. If diagnosis and treatment are not performed in a timely manner, PID may cause sepsis, septic shock, and even death. Even if they survive, as many as 15% to 20% of these women experience long-term sequelae of PID, such as ectopic pregnancy, tubo-ovarian abscess, infertility, dyspareunia, and chronic pelvic pain. The best treatments for PID are interventions that lead to prevention and early detection. The critical care nurse has an important role in recognizing the variables that may lead to PID-related sepsis and in encouraging health-seeking and health-maintenance behaviors among women with these diagnoses.
Topics: Adolescent; Anti-Infective Agents; Female; Humans; Nurse-Patient Relations; Pelvic Inflammatory Disease; Risk Factors; Sepsis; Sexually Transmitted Diseases
PubMed: 12597041
DOI: 10.1016/s0899-5885(02)00031-x -
Danish Medical Bulletin Feb 1988
Review
Topics: Abortion, Induced; Anti-Bacterial Agents; Female; Genitalia, Female; Humans; Pelvic Inflammatory Disease; Pregnancy; Pregnancy Trimester, First; Premedication; Risk Factors
PubMed: 3277798
DOI: No ID Found -
Srpski Arhiv Za Celokupno Lekarstvo 2010Pelvic inflammatory disease (PID) is polymicrobial infection in women characterized by inflammation of the upper genital tract, including endometritis, salpingitis,... (Review)
Review
Pelvic inflammatory disease (PID) is polymicrobial infection in women characterized by inflammation of the upper genital tract, including endometritis, salpingitis, pelvic peritonitis, occasionally leading to the formation of tubo-ovarian abscess (TOA). PID primarily affects young, sexually active women, and it is highly correlated with having several sexual partners, intrauterine contraceptive device and sexually transmitted diseases. The spectrum of disease is caused most commonly by Chlamydia trachomatis and Neisseria gonorrhoeae in 30-50% of cases. PID is responsible for severe acute morbidity and significant long-term sequelae, including tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. The following clinical features are suggestive of a diagnosis of PID: bilateral lower abdominal tenderness, abnormal vaginal or cervical discharge, fever (higher than 38 degrees C), abnormal vaginal bleeding, dyspareunia, cervical motion tenderness and adnexal tenderness, with or without a palpable mass. In laboratory findings, there is presence of excess leucocytes, elevated erythrocyte sedimentation rate or C-reactive protein. Transvaginal ultrasound scanning may be helpful, and its sensitivity is up to 85%. It can identify inflamed and dilated tubes and tubo-ovarian masses. Magnetic resonance imaging can be helpful in a final diagnosis in 95% of cases. In 15-30% of suspected cases, there is no laparoscopic evidence of disease. Treatment regimens for PID include broad-spectrum antibiotics, including coverage for Neisseria gonorrhoeae and Chlamydia trachomatis. The usage of parenteral or oral therapy, inpatient or outpatient regimens, depends on the patient's clinical condition. Considering the potential complications of disease, there is a need for good health educational programmes in reproductive period.
Topics: Female; Humans; Pelvic Inflammatory Disease
PubMed: 21180100
DOI: 10.2298/sarh1010658t -
Journal of Obstetric, Gynecologic, and... Oct 1995Acute pelvic inflammatory disease (PID) adversely affects the health of 1 million American women annually. The best understood etiologic organisms are Chlamydia... (Review)
Review
Acute pelvic inflammatory disease (PID) adversely affects the health of 1 million American women annually. The best understood etiologic organisms are Chlamydia trachomatis and Neisseria gonorrhea; however, information regarding the contributions of facultative and causative anaerobes continues to emerge. Chronic PID presents a diagnostic and management challenge to health care providers. Because of morbidity and sequelae the importance of early detection of, and intervention for, upper tract pelvic infections cannot be overemphasized. Nursing interventions in PID prevention, early assessment, accurate diagnosis, and thorough treatment can have a positive impact on women's health.
Topics: Adolescent; Chlamydia Infections; Diagnosis, Differential; Female; Gonorrhea; Humans; Pelvic Inflammatory Disease; Risk Factors; United States
PubMed: 8551374
DOI: 10.1111/j.1552-6909.1995.tb02560.x -
British Journal of Obstetrics and... Dec 1992
Topics: Anti-Infective Agents; Female; Humans; Pelvic Inflammatory Disease
PubMed: 1477012
DOI: 10.1111/j.1471-0528.1992.tb13693.x -
Papua and New Guinea Medical Journal Mar 1987
Topics: Female; Humans; Pelvic Inflammatory Disease
PubMed: 3475863
DOI: No ID Found -
Pediatric Clinics of North America Aug 1999Pelvic inflammatory disease is the most significant consequence of sexually transmitted infections. Statistics suggest that adolescents have a significantly higher rate... (Review)
Review
Pelvic inflammatory disease is the most significant consequence of sexually transmitted infections. Statistics suggest that adolescents have a significantly higher rate of PID than does any other age group. Even asymptomatic and minimally symptomatic PID can lead to adhesions, infertility, and ectopic pregnancy, so clinicians should maintain a high index of suspicion when evaluating female adolescents with lower abdominal pain. Empiric treatment, including appropriate partner notification and treatment, should be initiated early.
Topics: Adolescent; Diagnosis, Differential; Female; Humans; Patient Education as Topic; Pelvic Inflammatory Disease; Pregnancy; Pregnancy Complications, Infectious; Risk Factors
PubMed: 10494256
DOI: 10.1016/s0031-3955(05)70151-6