Please enable JavaScript.
Coggle requires JavaScript to display documents.
PELVIC INFLAMMATORY DISEASE - Coggle Diagram
PELVIC INFLAMMATORY DISEASE
Definition
Infection & inflammation of upper female genital tract. Involves uterus, fallopian tubes, ovaries ± peritoneum.
Clinical features
Dyspareunia, dysuria
Irregular vaginal bleeding
Abnormal vaginal discharge
Fever, malaise (in severe cases)
Lower abdominal/pelvic pain
Pathophysiology
Common pathogens: Chlamydia trachomatis, Neisseria gonorrhoeae, anaerobes
Inflammation → tubal damage, adhesions, infertility risk
Ascending infection from lower genital tract
Investigations
CBC, CRP, ESR
Pelvic ultrasound (rule out abscess)
NAAT swabs for Chlamydia & Gonorrhea
Laparoscopy (gold standard if diagnosis uncertain)
Pregnancy test (exclude ectopic)
Treatment
Inpatient: IV cefoxitin/ceftriaxone + doxycycline
Drainage of abscess if present
Outpatient: ceftriaxone + doxycycline ± metronidazole
Partner notification & treatment
Broad-spectrum antibiotics (covering N. gonorrhoeae, C. trachomatis, anaerobes)
Examination findings
Cervical motion tenderness ("chandelier sign")
Adnexal tenderness ± mass
Lower abdominal tenderness
Purulent cervical/vaginal discharge
Prevention
Screening & treatment of STIs
Limiting number of sexual partners
Safe sex practices (condoms)
Early treatment of lower genital tract infections
Risk factors
Recent IUD insertion
Bacterial vaginosis
Young age (<25 years)
Previous PID
Unprotected intercourse
Multiple sexual partners