Pelvic Inflammatory Disease Flashcards
What is PID?
The result of an infection ascending from the endocervix causing endometritis, salpingitis, parametritis, oophoritis, tubo-ovzrian abscess and/or pelvic peritonitis
What is endometritis?
Inflammation of endometrium
What is salpingitis?
Inflammation of the ovarian tubes
What is parametritis?
Inflammation of the parametrium
What is oophoritis?
Inflammation of the ovary
What is the pathophysiology of PID?
Ascending infection from endocervix + vagina
Infection causes inflammation
Inflammation causes damage
What can cause PID?
STI
- chlamydia
- gonorrhoea
Gardnerella vaginalis
Mycoplasma hominis
Actinomycosis
What is actinomycosis?
Bacterial infection - can be caused by IUD
What are risk factors for PID?
Young age Lack of barrier contraception Multiple sexual partners Low socioeconomic class IUD
What are the clinical features of PID?
Pain - lower abdomen Fever Abnormal discharge Abnormal vaginal bleeding Pain on deep penetration
What are differential diagnoses for suspected PID?
Ectopic pregnancy Endometriosis Functional pain IBS Appendicitis UTI
How is suspected PID investigated?
STI screen
- Endocervical swab
- high vaginal swab
Pregnancy test
Bloods
- FBC
- CRP
Gold standard = diagnostic laparoscopy
What is the management of PID?
Antibiotics
- ceftriaxone
- doxycycline
- metronidazole
Analgesia
Admission
Contact tracing
What are potential complications of PID?
Ectopic pregnancy Infertility Chronic pelvic pain Fitz-Hugh-Curtis Syndrome Reiter Syndrome
What is Fitz-Hugh-Curtis syndrome?
RUQ pain and peri-hepatitis following chlamydial PID
