Pelvic Inflammatory Disease Flashcards
What is PID?
inflammation and infection of the organs of the pelvis
what causes PID?
infection spreading up through the cervix
2 significant outcomes of PID
tubular infertility
chronic pelvic pain
salpingitis
inflammation of fallopian tubes
oophritis
inflammation of ovaries
parametritis
inflammation of parametrium
parametrium
connective tissue around the uterus
main cause of PID
STIs
3 main STIs which can cause PID
Neisseria gonorrhoea
chalmydia trachomatis
mycoplasma genitalia
less common causes of PID
gardnerella vaginalis - BV
H influenzae - rep infections
E coli - UTI
Risk factors for PID
no barrier contraception multiple sexual partners younger age existing STi previous PID IUD eg copper coil
presentation
pelvic or lower abdo pain abnormal discharge or bleeding dyspareunia fever dysuria
examination findings
pelvic tenderness
cervical motion tenderness/excitation
inflamed cervix
purulent discharge
testing for causative STI
NAAT for gonorrhoea, chalmydia and mycoplasma genitalium
HIV test
syphilis test
investigations
STI tests - NAAT and bloods
high vaginal swab - BV, candidiasis
pregnancy test
inflammatory markers
what can a microscope detect?
pus cells
why should a pregnancy test be done?
exclude ectopic pregnancy
management
Refer to GUM contact tracing im ceftriaxone 1g doxycycline 14 days 100mg metronidazole 400mg 14 days
complications of PID
sepsis abscess infertility chronic pelvic pain ectopic pregnancy Fitz-Hugh-Curtis syndrome
what is Fitz-Hugh-Curtis syndrome
inflammation and infection of liver capsule
adhesions between liver and peritoneum
presentation of Fitz-Hugh-Curtis syndrome
RUQ pain –> right shoulder tip
managing Fitz-Hugh-Curtis syndrome
laparoscopy
adhesiolysis
