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Pelvic Inflammatory Disease

Pelvic inflammatory disease

Radswiki et al.

Pelvic inflammatory disease (PID) is a broad term that encompasses a spectrum of infection and

 inflammation of the upper female genital tract, resulting in a spectrum of abnormalities. 


Epidemiology


The highest incidence is seen among sexually active women in their teens, with 75% cases being

 under 25 years of age.  In the United States approximately 1 million females are thought to be 

afflicted with PID per year and nearly 275,000 of them are thought to be hospitalised 7.


Clinical presentation


More common presentations include acute pelvic pain (of variable intensity), cervical motion 

tenderness, vaginal discharge, fever, and leukocytosis. Right upper quadrant pain from the 

perihepatitis in Fitz-Hugh-Curtis syndrome is possible.


Pathology


PID is defined as an acute clinical syndrome associated with ascending spread of micro-organisms, 

unrelated to pregnancy or surgery. The infection generally ascends from the vagina or cervix to the

 endometrium (endometritis), then to the fallopian tubes (salpingitis), and then to and/or contiguous

 structures (tubo-ovarian abscess). 


It can result from number of causative organisms:


common

Chlamydia trachomatis: pelvic chlamydial infection

Neisseria gonorrhoeae: pelvic gonococcal infection

polymicrobial infection: can account for ~ 35% of cases 3

less common

Mycobacterium tuberculosis: pelvic tuberculous infection

Actinomyces sp.: pelvic actinomyces infection

PID is usually bilateral, except when it is caused by the direct extension of an adjacent inflammatory 

process such as appendiceal, diverticular, or post-surgical abscesses.


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