Pelvic inflammatory disease (PID)

Question 1

What is PID?

Answer 1

Inflammation and infection of the organs of the pelvis, caused by infection spreading up through the cervix

Question 2

Most cases of PID are caused by an STI, name the 3 commonest cause, and which of these 3 causes the most severe PID?

Answer 2

• Neisseria gonorrhoeae (more severe PID)
• Chlamydia trachomatis
• Mycoplasma genitalium

Question 3

PID can less commonly be caused by non-STIs - name one of these causes

Answer 3

• Gardnerella vaginalis
• Haemophilus influenzae
• Escherichia coli

Question 4

Name 2 ways women with PID may present

Answer 4

• Pelvic or lower abdominal pain
• Abnormal vaginal discharge
• Abnormal bleeding (intermenstrual or postcoital)
• Pain during sex
• Fever
• Dysuria

Question 5

As well as testing for the causative agent, name another investigation that would be done for PID

Answer 5

• Pregnancy test (for ectopic)
• Inflammatory markers

Question 6

Name 2 complications of PID

Answer 6

• Sepsis
• Abscess
• Infertility
• Chronic pelvic pain
• Ectopic pregnancy
• Fitz-Hugh-Curtis syndrome

Question 7

1) What is Fitz-Hugh-Curtis-syndrome?
2) What symptom does this result in?

Answer 7

1) Inflammation and infection of the liver capsule (Glisson’s capsule), leading to adhesions between the liver and peritoneum
2) RUQ pain (can be referred to the right shoulder tip if there is diaphragmatic irritation)