PID

Question 1

what is PID?

Answer 1

inflammation of organs of the pelvis

-when infection spreads from vagina through into the cervix and into the upper genital tract (uterus, fallopian tubes, ovaries)

Question 2

STI causes of PID?

Answer 2

-neisseria gonorrhoea (tends to cause severe PID)
-Chlamydia trachomatis
-Mycoplasma Genitalium

Question 3

Non STI causes of PID?

Answer 3

-Gardnerella vaginalis
-Haemophilus Influenxae
-E.Coli

Question 4

What contraceptive increases risk of PID?

Answer 4

Copper coil

Question 5

symptoms/ signs of PID?

Answer 5

-Fever
-Pain
-Discharge
-Cervical excitation
-Deep dyspareunia

Question 6

investigations for PID?

Answer 6

NAAT
-swab for gonorrhoea and chlamydia

High vaginal swab to look for bacterial vaginosis, candidiasis and trichomoniasis

Pregnancy test (exclude ectopic pregnancy)

Microscope to look for pus cells on swabs- if absent can exclude PID

Raised inflammatory markers (CRP and ESR)

Question 7

Management PID?

Answer 7

Outpatients= olfoxacin + metranidazole

In patients=
-IM ceftriaxone (cover gonorrhoea)
-Doxycycline (cover chlamydia and mycoplasma genitalium)
-Metranidazole

Signs of sepsis- adsmission for IV antibiotics
If pelvic abscess- drain it

Question 8

complications PID?

Answer 8

Sepsis
Abscess
Infertility
Chronic pelvic pain
Ectopic Pregnancy
Fitz- High- Curtis Syndrome

Question 9

what is Fitz Hugh Curtis syndrome and how does it present?

Answer 9

Rare disorder causes inflammation of the lining of the stomach, tissues surrounding the liver and sometimes even the diaphragm

-complication of PID (caused by Chlamydia Trachomatis + Gonorrhoea Neisseria)

-Sudden onset of severe pain in RUQ