29) Pelvic Inflammatory Disease (PID)

Question 1

What is Pelvic Inflammatory Disease?

Answer 1

• Inflammation of the Pelvic Structures
• Where there’s an ascending infection from Cervix –> Uterus –> FT + Ovaries

INFECTION OF:

• Endometrium - Endometritis
• Oviducts- Salpingitis
• Ovaries- Oophoritis
• Uterine Wall- Myometritis

NB! Affecting Women ages 20 - 40 Years Old, and LEADING CAUSE of INFERTILITY

Question 2

What are the Types of PID?

Answer 2

1) Acute - Generalised Sx from ascending infection

2) Chronic - chronic pelvic pain

3) Silent (Asymptomatic)

Question 3

What are the CAUSES of PID?

Answer 3

• Chlamydia Trachomatis
• Neiserria Gonorrhoea
• E.Coli
• G. Vaginalis

RFs

• Multiple Sex Partners
• Unprotected Sex
• IUD
• History of STI

Question 4

What is the Pathophysiology?

Answer 4

1) Infection ascends from Lower genital tract

2) Affecting the endometrium, tubes, ovaries + Peritoneal Cavity

3) Due to retrograde menstruation, sexual intercourse, or Bacterial Vaginosis

Question 5

What are the Clinical Features?

Answer 5

• Lower Abdominal / Pelvic pain
• Nausea / Vomiting
• Fever
• Urinary Sx - Dysuria, Frequency, Urgency
• Dyspareunia (Painful Sex)
• Abnormal Vaginal Discharge

Question 6

How is PID Diagnosed and Treated?

Answer 6

DIAGNOSIS

• Vaginal Exam - Cervical Motion / Uterine tenderness
• Increased ESR / Leukocytosis
• Cervical Swap for Culture
• Pelvic Ultrasound

TREATMENT

• Empirical Antibiotics
• IM Ceftriaxone and Oral Doxyclcine

Question 7

What are the Complications of PID?

Answer 7

• Pelvic Peritonitis
• Inflammation of Liver Capsule
• Tubo-Ovarian Abscess
• Ectopic Pregnancy