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The Journal of the American Osteopathic... Jul 2020
Topics: Female; Gonorrhea; Hepatitis; Humans; Pelvic Inflammatory Disease; Peritonitis
PubMed: 32598463
DOI: No ID Found -
Gynecologie, Obstetrique, Fertilite &... May 2019The objective of this literature review is to update the recommendations for clinical practice about the diagnosis of pelvic inflammatory disease (PID), microbiologic... (Review)
Review
The objective of this literature review is to update the recommendations for clinical practice about the diagnosis of pelvic inflammatory disease (PID), microbiologic diagnosis excluded. An adnexal pain or cervical motion tenderness are the signs that allow a positive diagnosis of PID (LE2). Associated signs (fever, leucorrhoea, metrorrhagia) reinforce clinical diagnosis (LE2). In a woman consulting for symptoms compatible with PID, a pelvic clinical examination is recommended (grade B). In cases of suspected PID, hyperleukocytosis associated with a high C-reactive protein suggests a complicated PID or a differential diagnosis such as acute appendicitis (LE3). The absence of hyperleukocytosis or normal CRP does not rule out the diagnosis of PID (LE1). When PID is suspected, a blood test with a blood count and a CRP test is recommended (grade C). Pelvic ultrasound scan does not contribute to the positive diagnosis of uncomplicated PID because it is insensitive and unspecific (LE3). However, ultrasound scan is recommended to look for signs of complicated PID (polymorphic collection) or differential diagnosis (grade C). Waiting for an ultrasound scan to be performed should not delay the start-up of antibiotic therapy. In case of diagnostic uncertainty, an abdominal-pelvic CT scan with contrast injection is useful for differential diagnosis of urinary, digestive or gynaecological origin (LE2). Laparoscopy is not recommended for the unique purpose of the positive diagnosis of PID (grade B).
Topics: Appendicitis; Blood Cell Count; C-Reactive Protein; Diagnosis, Differential; Female; Humans; Laparoscopy; Leukocytosis; Pelvic Inflammatory Disease; Pelvic Pain; Tomography, X-Ray Computed; Ultrasonography
PubMed: 30878687
DOI: 10.1016/j.gofs.2019.03.010 -
Korean Journal of Radiology Apr 2021The perihepatic space is frequently involved in a spectrum of diseases, including intrahepatic lesions extending to the liver capsule and disease conditions involving... (Review)
Review
The perihepatic space is frequently involved in a spectrum of diseases, including intrahepatic lesions extending to the liver capsule and disease conditions involving adjacent organs extending to the perihepatic space or spreading thanks to the communication from intraperitoneal or extraperitoneal sites through the hepatic ligaments. Lesions resulting from the dissemination of peritoneal processes may also affect the perihepatic space. Here we discuss how to assess the perihepatic origin of a lesion and describe the magnetic resonance imaging (MRI) features of normal structures and fluids that may be abnormally located in the perihepatic space. We then review and illustrate the MRI findings present in cases of perihepatic infectious, tumor-related, and miscellaneous conditions. Finally, we highlight the value of MRI over computed tomography.
Topics: Abscess; Endometriosis; Female; Hepatitis; Humans; Liver; Magnetic Resonance Imaging; Pelvic Inflammatory Disease; Peritoneal Diseases; Peritoneum; Peritonitis; Tomography, X-Ray Computed
PubMed: 33236541
DOI: 10.3348/kjr.2019.0774 -
The Indian Journal of Medical Research Jan 2017
Topics: Abdomen; Adult; Azithromycin; Cephalosporins; Chlamydia Infections; Female; Hepatitis; Humans; Liver; Pelvic Inflammatory Disease; Peritonitis; Young Adult
PubMed: 28574030
DOI: 10.4103/ijmr.IJMR_1417_15 -
BMJ Case Reports Feb 2019
Topics: Adult; Anti-Bacterial Agents; Azithromycin; Chlamydia Infections; Chlamydia trachomatis; Female; Hepatitis; Humans; Liver; Pelvic Inflammatory Disease; Peritonitis; Tomography, X-Ray Computed
PubMed: 30765452
DOI: 10.1136/bcr-2019-229326 -
BMJ Clinical Evidence Dec 2013Pelvic inflammatory disease is caused by infection of the upper female genital tract and is often asymptomatic. Pelvic inflammatory disease is the most common... (Review)
Review
INTRODUCTION
Pelvic inflammatory disease is caused by infection of the upper female genital tract and is often asymptomatic. Pelvic inflammatory disease is the most common gynaecological reason for admission to hospital in the US, and is diagnosed in approximately 1% of women aged 16 to 45 years consulting their GP in England and Wales.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical questions: How do different antimicrobial regimens compare when treating women with confirmed pelvic inflammatory disease? What are the effects of routine antibiotic prophylaxis to prevent pelvic inflammatory disease before intrauterine contraceptive device (IUD) insertion? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up to date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA), the European Medicines Agency (EMA), and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 13 RCTs or systematic reviews of RCTs that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review, we present information relating to the effectiveness and safety of the following interventions: antibiotics (oral, parenteral, different durations, different regimens) and routine antibiotic prophylaxis (before intrauterine device insertion in women at high risk or low risk).
Topics: Acute Disease; Anti-Bacterial Agents; Anti-Infective Agents; Antibiotic Prophylaxis; Hospitalization; Humans; Pelvic Inflammatory Disease
PubMed: 24330771
DOI: No ID Found -
Disease-a-month : DM Aug 2016
Review
Topics: Female; Humans; Pelvic Inflammatory Disease; Sexually Transmitted Diseases; United States
PubMed: 27107781
DOI: 10.1016/j.disamonth.2016.03.015 -
Infectious Diseases in Obstetrics and... 2011
Topics: Female; Humans; Pelvic Inflammatory Disease
PubMed: 22547912
DOI: 10.1155/2011/714289 -
American Family Physician Apr 2012Pelvic inflammatory disease is a polymicrobial infection of the upper genital tract. It primarily affects young, sexually active women. The diagnosis is made clinically;... (Review)
Review
Pelvic inflammatory disease is a polymicrobial infection of the upper genital tract. It primarily affects young, sexually active women. The diagnosis is made clinically; no single test or study is sensitive or specific enough for a definitive diagnosis. Pelvic inflammatory disease should be suspected in at-risk patients who present with pelvic or lower abdominal pain with no identified etiology, and who have cervical motion, uterine, or adnexal tenderness. Chlamydia trachomatis and Neisseria gonorrhoeae are the most commonly implicated microorganisms; however, other microorganisms may be involved. The spectrum of disease ranges from asymptomatic to life-threatening tubo-ovarian abscess. Patients should be treated empirically, even if they present with few symptoms. Most women can be treated successfully as outpatients with a single dose of a parenteral cephalosporin plus oral doxycycline, with or without oral metronidazole. Delay in treatment may lead to major sequelae, including chronic pelvic pain, ectopic pregnancy, and infertility. Hospitalization and parenteral treatment are recommended if the patient is pregnant, has human immunodeficiency virus infection, does not respond to oral medication, or is severely ill. Strategies for preventing pelvic inflammatory disease include routine screening for chlamydia and patient education.
Topics: Administration, Oral; Anti-Bacterial Agents; Biopsy; Chlamydia trachomatis; Diagnostic Imaging; Drug Therapy, Combination; Endometrium; Female; Gynecological Examination; Hospitalization; Humans; Infusions, Parenteral; Male; Mass Screening; Medical History Taking; Neisseria gonorrhoeae; Nucleic Acid Amplification Techniques; Pelvic Inflammatory Disease; Pregnancy; Risk Factors; Sexual Partners
PubMed: 22534388
DOI: No ID Found -
The Journal of Infectious Diseases Jul 2017Mycoplasma genitalium is very difficult to grow in culture but has been more able to be studied for disease associations since the advent of research molecular... (Review)
Review
BACKGROUND
Mycoplasma genitalium is very difficult to grow in culture but has been more able to be studied for disease associations since the advent of research molecular amplification assays. Polymerase chain reaction (PCR) and other molecular assays have demonstrated an association with adverse disease outcomes, such as urethritis or nongonococcal urethritis in men and adverse reproductive sequelae in women-for example, cervicitis, endometritis, and pelvic inflammatory disease (PID), including an association with risk for human immunodeficiency virus. The lack of commercially available diagnostic assays has limited widespread routine testing. Increasing reports of high rates of resistance to azithromycin detected in research studies have heightened the need available commercial diagnostic assays as well as standardized methods for detecting resistance markers. This review covers available molecular methods for the diagnosis of M. genitalium and assays to predict the antibiotic susceptibility to azithromycin.
METHODS
A PubMed (US National Library of Medicine and National Institutes of Health) search was conducted for literature published between 2000 and 2016, using the search terms Mycoplasma genitalium, M. genitalium, diagnosis, and detection.
RESULTS
Early PCR diagnostic tests focused on the MPa adhesion gene and the 16S ribosomal RNA gene. Subsequently, a transcription-mediated amplification assay targeting ribosomes was developed and widely used to study the epidemiology of M. genitalium. Newer methods have proliferated and include quantitative PCR for organism load, AmpliSens PCR, PCR for the pdhD gene, a PCR-based microarray for multiple sexually transmitted infections, and multiplex PCRs. None yet are cleared by the Food and Drug Administration in the United States, although several assays are CE marked in Europe. As well, many research assays, including PCR, gene sequencing, and melt curve analysis, have been developed to detect the 23S ribosomal RNA gene mutations that confer resistance to azithromycin. One recently developed assay can test for both M. genitalium and azithromycin resistance mutations at the same time.
CONCLUSIONS
It is recommended that more commercial assays to both diagnose this organism and guide treatment choices should be developed and made available through regulatory approval. Research is needed to establish the cost-effectiveness of routine M. genitalium testing in symptomatic patients and screening in all individuals at high risk of acquiring and transmitting sexually transmitted infections.
Topics: Anti-Bacterial Agents; Azithromycin; Drug Resistance, Bacterial; Female; Humans; Macrolides; Male; Multiplex Polymerase Chain Reaction; Mutation; Mycoplasma Infections; Mycoplasma genitalium; Pelvic Inflammatory Disease; RNA, Ribosomal, 16S; Urethritis; Uterine Cervicitis
PubMed: 28838072
DOI: 10.1093/infdis/jix104