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Pelvic Inflammatory Disease

Pelvic Inflammatory Disease is a topic covered in the 5-Minute Emergency Consult.

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  • Pelvic inflammatory disease (PID) is an acute, community-acquired, sexually transmitted infection of the upper genital tract, including the uterus, fallopian tubes, ovaries, or adjacent structures
  • Most frequent gynecologic cause for ED visits (350,000 per year)
  • Represents a spectrum of infection:
    • No single diagnostic gold standard
    • Requires low clinical threshold for considering the diagnosis and starting empiric antibiotic therapy
  • Progressive disease can lead to tubo-ovarian abscess (TOA)
  • Fitz-Hugh–Curtis syndrome is a capsular inflammation of the liver associated with PID:
    • Sharp right upper quadrant abdominal pain
    • Worse with inspiration, movement, or coughing


  • Risk factors:
    • Age <25 yr
    • Multiple or symptomatic sexual partners
    • Previous episode of PID
    • Nonbarrier contraception
    • Oral contraception
    • African American ethnicity
  • Most common causes of PID are Chlamydia trachomatis and Neisseria gonorrhea
  • Other organisms include groups A and B streptococci, staphylococci, gram-negative rods (commonly Klebsiella spp., Escherichia coli, and Proteus spp.), and anaerobes

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Rosen, Peter, et al., editors. "Pelvic Inflammatory Disease." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307272/all/Pelvic_Inflammatory_Disease.
Pelvic Inflammatory Disease. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307272/all/Pelvic_Inflammatory_Disease. Accessed April 25, 2019.
Pelvic Inflammatory Disease. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307272/all/Pelvic_Inflammatory_Disease
Pelvic Inflammatory Disease [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307272/all/Pelvic_Inflammatory_Disease.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Pelvic Inflammatory Disease ID - 307272 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307272/all/Pelvic_Inflammatory_Disease PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -