Pelvic Inflammatory Disease

Question 1

what is a polymicrobial infection of the upper genital tract, commonly associated with gonorrhoeae and chlamydia, anaerobes, haemophilus influenzae, strep?

Answer 1

Pelvic Inflammatory disease

Question 2

what population is PID most common in?

Answer 2

young, nulliparous, sexually active women with multiple partners and is a leading cause of infertility and ectopic pregnancy.

Question 3

when is PID more likely to occur?

Answer 3

HX of PID
sexual contact
recent menses
insertion of an IUD

Question 4

what is the minimum diagnostic criteria for treatment of PID?

Answer 4

cervical motion tenderness, uterine, or adnexal tenderness should be treated with antibiotics unless there is a competing diagnosis such as ectopic pregnancy or appendicitis.

Question 5

what are some signs and SX of PID?

Answer 5

Lower abdomen pain
fever, chills
menstrual disturbances
purulent cervical discharge
cervical and adnexal tenderness

mild sx:
postcoidal bleeding
urinary frequency
low back pain

Question 6

what labs are we running for PID?

Answer 6

pregnancy
endocervical evaluation for chlamydia, gonorrhea, and other pathogens.

Question 7

antibiotic treatment for PID of possible gonorrhea and chlamydia origins:

Answer 7

Ceftriaxone
metronidazole

severe disease:
cefoxitin IV then doxy for 14 days.

Question 8

When should you MEDEVAC PID?

Answer 8

pregnancy
tubo-ovarian cancer
unable to follow treatment regiment
no response in 72 hrs from treatment
severe illness or can’t rule out appendicitis