Pelvic inflammatory disease

Abstract

Introduction Pelvic inflammatory disease (PID) represents a spectrum of infection that can include the cervix, the uterus, and fallopian tubes. The infection can begin as very subtle, almost asymptomatic, infection that can go unnoticed by the patient. It is this very presentation that makes PID a very dangerous infection associated with significant morbidity and contributes significantly to the cost of healthcare. It is a difficult disease to diagnosis and may be over- as well as underdiagnosed. Although PID can be perplexing at times, the syndrome can be divided into two categories based on the clinical presentation, findings, and mode of treatment: (1) infection caused by Chlamydia trachomatis and/or Neisseria gonorrhoeae, and (2) polymicrobial infection. The latter can be preceded by either or both C. trachomatis and N. gonorrhoeae infection and involves bacteria derived from the endogenous vaginal microflora. The goal in treating PID is to establish a correct diagnosis as early in the course of the disease as possible and prevent the potential sequelae. Therefore, evaluation of the patient suspected of having PID should be made only after ruling out other possible diagnoses that may have more significant immediate morbid consequence for the patient. Epidemiology Data from the National Hospital Discharge Survey revealed that the number of acute cases per year plateaued at approximately 60 000–65 000 from 2001 to approximately 2004.