Concept and Etiology:
Pelvic inflammatory disease (PID) is a clinical syndrome that results
from the ascension of microorganisms from the cervix and vagina to
the upper genital tract. PID is a serious complication of chlamydia and
gonorrhea, two of the most common reportable infectious diseases
and sexually transmitted diseases (STDs) in the US. a According to the
CDC, PID diagnoses are in an average of 5% of all U.S. women will
have PID in their lifetime. It most often occurs when sexually
transmitted bacteria spread from your vagina to your uterus, fallopian
tubes or ovaries.
Classification:
Pelvic inflammatory disease (PID) is an infection of the female
reproductive organs. It most often occurs when sexually transmitted
bacteria spread from your vagina to your uterus, fallopian tubes or
ovaries. Sexually transmitted organisms, especially Gonorrhea and
Chlamydia, are implicated in many cases.
Clinical Manifestations:
The signs and symptoms of pelvic inflammatory disease can be subtle
or mild. Some women don't experience any signs or symptoms,
however some signs and symptoms could be:
• oral temperature >101°F (>38.3°C);
• abnormal cervical mucopurulent discharge or cervical friability;
• presence of abundant numbers of WBC on saline microscopy of
vaginal fluid;
• elevated erythrocyte sedimentation rate;
• elevated C-reactive protein; and
• laboratory documentation of cervical infection with
N.
gonorrhoeae
or
C. trachomatis
.
As a result, you might not realize you have it until you have trouble
getting pregnant or you develop chronic pelvic pain.
Diagnostic Tests:
• History
• Physical examination
• Discharge culture
• Pap smear
• CBC
• pelvic ultrasound
• CT
The most specific criteria for diagnosing PID include:
• endometrial biopsy with histopathologic evidence of
endometritis;
• transvaginal sonography or magnetic resonance imaging
techniques showing thickened, fluid-filled tubes with or without
free pelvic fluid or tubo-ovarian complex, or Doppler studies
suggesting pelvic infection (e.g., tubal hyperemia); or
• laparoscopic findings consistent with PID.
References
Mayo Foundation for Medical Education and Research. (2020, April
23).
Pelvic inflammatory disease (PID)
. Mayo Clinic. Retrieved
November 26, 2021, from https://www.mayoclinic.org/diseases-
conditions/pelvic-inflammatory-disease/symptoms-causes/syc-
20352594.
Story, L. (2018). Pelvic Inflammatory Disease. In
Pathophysiology: A
practical approach
(pp. 242–243). essay, Jones & Bartlett Learning.
Center for Disease Control and Prevention (2020).
Pelvic
inflammatory disease (PID).
CDC. November 26, 2021 from
https://www.cdc.gov/std/pid/stdfact-pid-detailed.htm
