PID

Question 1

What is PID (organisms, RF)

Answer 1

Result of an ascending infection of genital area (endomitrium, ovarian, vaginal, cervix etc)-
most common cause is chlamydia
Other - anearobes, mycoplasma genitalium

RF– <25, early age of 1st sex, other sexial partners, recent change, hx of STI

Question 2

Sx and Ix of PID

Answer 2

can be asymptomatic (and present with inferitlity/chronic pelvic pain)
acutel- bilateral lower abdo pain, PV discharge, fever, PVB, dyspareunia + sx of the STI
Bimanual - cervical excitation, masses, PAINFUL TO TOUCH

Ix-
start Abx immediatly if suspect PID (mainly clinical based on bimanual
Triple swab (endocervical, High vaginal)
Speculum- enflam/discharge

if febrile - FBC, CRP, cultures

Question 3

Mx and complications of PID

Answer 3

ADMIT IF- pyrexial or sceptic
and give IV cefoxitin and IV doxycyline

if outpatient - reasses 2-3 days after abx
go for--
Ceftriaxine 500mg IM
doxy 100mg BD oral
Metrodinazole 400mg BD oral

+ STI screen, contact tacing, discuss contraception, removal of IUD, avoid sex
parnter treatment with doxy

complications- infertility, ectopic pregnanyc, chronic pevlic pain
(up to 30% need hospital)