pelvic%20inflammatory%20disease
PELVIC INFLAMMATORY DISEASE
Pelvic inflammatory disease (PID) is the ascent of bacteria from the vagina or cervix resulting in infection of the reproductive organs eg uterus, fallopian tubes, ovaries. It may also be a complication of sexually transmitted infections.
The most common symptoms of PID are lower abdominal pain (crampy or dull) that usually starts a few days after the onset of the last menstrual period, dyspareunia, abnormal vaginal or cervical discharge, postcoital or irregular vaginal bleeding, dysuria, fever, nausea and vomiting, although some have minimal symptoms or silent pelvic inflammatory disease.

Follow Up

  • Further review 4 wk after treatment may be useful to ensure the following:
    • Adequate clinical response
    • Compliance w/ oral antibiotics
    • Screening & treatment of sex partners/contacts
    • Recurrence prevention through condom use
  • Repeat testing for etiologic organisms may be warranted for patients w/ persistent symptoms, poor compliance w/ antibiotics, or possible reinfection
    • In patients w/ documented infection w/ C trachomatis N gonorrhoeae, some specialists recommend rescreening 4-6 wk after completion of treatment

Counselling

  • STI consultation allows for an opportunity to discuss patient’s risk factors for STIs & HIV
  • Determine patient’s risk for HIV & discuss HIV testing
  • Testing for HIV is recommended & should be offered to all persons seeking evaluation & treatment for STIs
    • Pretest & posttest counseling as well as informed consent are part of the testing procedure
    • Concomitant infection w/ HIV may complicate management & control of some STIs
    • HIV-infected patients w/ PID are more common to have tubo-ovarian abscess & usually require surgical intervention
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