Pelvic inflammatory disease

Contemporary diagnostic and therapeutic approach

Milan Terzić, Dušica Kocijančić

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Pelvic inflammatory disease (PID) is polymicrobial infection in women characterized by inflammation of the upper genital tract, including endometritis, salpingitis, pelvic peritonitis, occasionally leading to the formation of tubo-ovarian abscess (TOA). PID primarily affects young, sexually active women, and it is highly correlated with having several sexual partners, intrauterine contraceptive device and sexually transmited diseases. The spectrum of disease is caused most commonly by Chlamydia trachomatis and Neisseria gonorrhoeae in 30-50% of cases. PID is responsible for severe acute morbidity and significant long-term sequelae, including tubal factor infertility, ectopic pregnancy, and chronic pelvic pain. The following clinical features are suggestive of a diagnosis of PID: bilateral lower abdominal tenderness, abnormal vaginal or cervical discharge, fever (higher than 38°C), abnormal vaginal bleeding, dyspareunia, cervical motion tenderness and adnexal tenderness, with or without a palpable mass. In laboratory findings, there is presence of excess leucocytes, elevated erythrocyte sedimentation rate or C-reactive protein. Transvaginal ultrasound scanning may be helpful, and its sensitivity is up to 85%. It can identify inflamed and dilated tubes and tubo-ovarian masses. Magnetic resonance imaging can be helpful in a final diagnosis in 95% of cases. In 15-30% of suspected cases, there is no laparoscopic evidence of disease. Treatment regimens for PID include broadspectrum antibiotics, including coverage for Neisseria gonorrhoeae and Chlamydia trachomatis. The usage of parenteral or oral therapy, inpatient or outpatient regimens, depends on the patient's clinical condition. Considering the potential complications of disease, there is a need for good health educational programmes in reproductive period.

Original languageEnglish
Pages (from-to)658-663
Number of pages6
JournalSrpski Arhiv Za Celokupno Lekarstvo
Volume138
Issue number9-10
DOIs
Publication statusPublished - Dec 1 2010
Externally publishedYes

Fingerprint

Pelvic Inflammatory Disease
Neisseria gonorrhoeae
Chlamydia trachomatis
Salpingitis
Dyspareunia
Therapeutics
Endometritis
Intrauterine Devices
Pelvic Pain
Uterine Hemorrhage
Ectopic Pregnancy
Sexual Partners
Blood Sedimentation
Peritonitis
Coinfection
Chronic Pain
C-Reactive Protein
Abscess
Infertility
Reproduction

Keywords

  • Diagnosis
  • Pelvic inflammatory disease
  • Treatment
  • Tubo-ovarin abscess

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pelvic inflammatory disease : Contemporary diagnostic and therapeutic approach. / Terzić, Milan; Kocijančić, Dušica.

In: Srpski Arhiv Za Celokupno Lekarstvo, Vol. 138, No. 9-10, 01.12.2010, p. 658-663.

Research output: Contribution to journalArticle

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