Pelvic Inflammatory Disease
Basics
Description
Description
- 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
- Occurs in 4.4% of women of reproductive age
- 85% of cases caused by sexually transmitted pathogens or bacterial vaginosis pathogens
- 15% of cases due to colonization of respiratory or enteric pathogens
- 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
- Delayed care is associated with worse long-term outcomes including chronic pelvic pain and increased risk of ectopic pregnancy
- Likely missed often and responsible for many cases of tubal-factor infertility
- 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
- Chronic PID:
- Symptoms > 30 d
- Mycobacterium tuberculosis
- Actinomyces
Etiology
Etiology
- Risk factors:
- Age <25 yr
- Earlier sexual activity:
- 8 times higher if sexually active at age 12 yr vs. 18 yr
- Multiple or symptomatic sexual partners
- Prior sexually transmitted infection
- Previous episode of PID
- Lesbian/bisexual relationships:
- Prevalence is 2 times higher
- Nonbarrier contraception
- Oral contraception
- African American ethnicity
- Most common causes of PID are:
- Chlamydia trachomatis
- Neisseria gonorrhoeae
- Other organisms include:
- Groups A and B streptococci
- Staphylococci
- Gram-negative rods (commonly Klebsiella spp., Escherichia coli, and Proteus spp.)
- Anaerobes
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Citation
Schaider, Jeffrey J., 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: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307272/all/Pelvic_Inflammatory_Disease. Accessed September 9, 2024.
Pelvic Inflammatory Disease. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307272/all/Pelvic_Inflammatory_Disease
Pelvic Inflammatory Disease [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2024 September 09]. 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
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T1 - Pelvic Inflammatory Disease
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ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307272/all/Pelvic_Inflammatory_Disease
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DB - Emergency Central
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