Pelvic Inflammatory Disease Flashcards
What is pelvic inflammatory disease?
When an infection spreads into the upper genital tract through the vagina and cervix
What are the most common causes of PID?
Chlamydia trachomatis
Neisseria gonorrhoea
What organism tends to cause more severe PID?
Neisseria gonorrhoea
How can PID be spread?
Predominantly sexually
Can also be contracted via UTI, respiratory infection and bacterial vaginosis
What are the non-sexually transmitted causes of PID?
E. coli
Gardnerella vaginalis
Haemophilus influenza
What are the risk factors for PID?
Not using barrier protection
Prior infection with chlamydia or gonorrhoea
Multiple sexual partners
IUD
Younger age
History of PID
What is the presentation of PID?
Pelvic (adnexal tenderness) or abdominal pain
Abnormal discharge
Abnormal bleeding - intermenstrual or postcoital
Dyspareunia
Dysuria
Fever
What might be found on pelvic examination?
Adnexal tenderness
Cervical motion tenderness
Uterine tenderness
What investigations are helpful in the diagnosis of PID?
Pelvic examination
NAAT swabs for gonorrhoea and chlamydia
Pregnancy test
Inflammatory markers
Transvaginal ultrasound
What is the treatment of PID?
IM ceftriaxone (gonorrhoea cover)
Doxycycline (chlamydia cover)
Metronidazole (for cover of aerobic bacteria)
14 days of antibiotics
What are the complications of PID?
Infertility
Chronic pelvic pain
Ectopic pregnancy
Fitz-Hugh-Curtis syndrome
What is Fitz-Hugh-Curtis syndrome?
Adhesions between the anterior liver capsule and the peritoneum, in someone with a background of PID
What is the presentation of Fitz-Hugh-Curtis syndrome?
Right upper quadrant pain
How is Fitz-Hugh-Curtis syndrome diagnosed?
Laparoscopy
What is seen on laparoscopy in Fitz-Hugh-Curtis syndrome?
Violin string perihepatic lesions, no involvement of the liver parenchyma
