pelvic inflammatory disease

  1. what is PID?
    Pelvic inflammatory disease (PID) is an infectious and inflammatory disorder of the upper female reproductive tract, including the uterus, fallopian tubes, and adjacent pelvic structures. It is a common and serious disorder, initiated by infection, that ascends from the vagina and cervix. PID may produce tubo-ovarian abscess and extend to produce pelvic peritonitis and Fitz-Hugh-Curtis syndrome
  2. pathophysiology?
    The first stage involves acquisition of a vaginal or cervical infection. The original sexually transmitted infection (STI) may be asymptomatic. An estimated 10-20% of untreated chlamydial or gonorrheal infections progress to PID. In PID, the second stage of upper female genital tract infection occurs by direct ascent of micro-organisms from the vagina and cervix.
  3. Symptoms?
    Abd pain: dull, aching or crampy, bilateral, and constant, dyspareunia, vaginal discharge/bleeding, elevated temp
  4. physical?
    lower abdominal tenderness, cervical motion tenderness, and uterine or adnexal tenderness.Mucopurulent cervicitis

    Temperature higher than 38.3°C (101°F)Abnormal cervical or vaginal mucopurulent discharge

    Presence of white blood cells (WBCs) on saline microscopy of vaginal secretions

    Elevated erythrocyte sedimentation rateElevated C-reactive protein level

    Laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis
  5. treatment
    Administer cefoxitin 2 g IV q6h or cefotetan 2 g IV q12h plus doxycycline 100 mg PO/IV q12h

    outpatient treatmentRegimen A: Administer ceftriaxone 250 mg IM once as a single dose plus doxycycline 100 mg PO bid for 14 days, with or without metronidazole 500 mg PO bid for 14 days.
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pelvic inflammatory disease
pelvic inflammatory disease