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Acute Pelvic Cellulitis
Acute female Pelvic Cellulitis

Presentation

Age and Sex edits from the Medicare Code Editor alert you to codes that are used only with patients of a specific age or sex, helping to ensure accurate reporting Present on Admission symbol highlights the diseases that will always be coded as present [books.google.com]

However, testicular tumors can present precipitously if they undergo hemorrhage or necrosis, and produce swelling, pain and soreness. [auanet.org]

The most common presentation is bilateral, palpable, fixed, tender masses. Patients often present with generalized abdominal pain and rebound tenderness caused by peritoneal inflammation. [www1.cgmh.org.tw]

A rash is not a prominent presenting sign in patients with streptococcal TSS. [glowm.com]

Although the Index leads to varicose veins, this code should not be assigned if no varicosities are present. [quizlet.com]

Entire Body System

  • Fever

    unspecified 5 A0101 Typhoid meningitis 6 A0102 Typhoid fever with heart involvement 7 A0103 Typhoid pneumonia 8 A0104 Typhoid arthritis 9 A0105 Typhoid osteomyelitis 10 A0109 Typhoid fever with other complications 11 A011 Paratyphoid fever A 12 A012 [hive-worx.com]

    Symptoms include Fever and chills Swollen glands or lymph nodes A rash with painful, red, tender skin. The skin may blister and scab over. [icdlist.com]

    Redness Tenderness Swelling Warmth of the affected area Pelvic Cellulitis (Parametritis) : Inflammation of the tissue adjacent to the uterus, particularly in the broad ligament Treatment Principle Herb Formulas Points Clinical Manifestations Slight fever [americandragon.com]

    Pyelonephritis: Other symptoms: high fevers that come and go along with chills / rigor. [healthtap.com]

    Signs and symptoms include pain, tenderness and reddening in the affected area, fever, chills, and lymphadenopathy. [fpnotebook.com]

  • Infertility

    Waiting too long increases the risk of infertility. [icdlist.com]

    […] associated with anovulation N97.1 Female infertility of tubal origin Female infertility associated with congenital anomaly of tube Female infertility due to tubal block Female infertility due to tubal occlusion Female infertility due to tubal stenosis [en.wikisource.org]

    ("uterus cold and infertile") Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow Treatment Principle Warm the Kidneys Drain Dampness Herb Formulas Points [americandragon.com]

    “Sexually transmitted diseases, pelvic inflammatory disease, and infertility: an epidemiologic update”. Epidemiol Rev. vol. 12. 1990. pp. 199-220. Donaldson, CK. “Acute Gynecologic Disorders”. Radiol Clin North Am. vol. 53. 2015 Nov. pp. 1293-307. [clinicaladvisor.com]

    Hernia repairs that use polypropylene mesh for correction may be associated with vas deferens obstruction and infertility later on. [auanet.org]

  • Ecchymosis

    Following blunt injury, the physical examination findings may include swelling, tenderness or ecchymosis. If one can clearly palpate the testis and it is entirely normal to palpation, rupture is unlikely. [auanet.org]

  • Severe Pain

    Infection of the tissues surrounding the eye causes redness, swollen eyelids, severe pain, and causes the eye to bulge out. [encyclopedia.com]

Gastrointestinal

  • Abdominal Pain

    Frequently, torsion resolves spontaneously, and the only presenting symptom is lower abdominal pain. [www1.cgmh.org.tw]

    pain that is worse with pressure Abdominal spasms and tension Immobile masses in the lower abdomen with pain and tenderness Amenorrhea with distention and pain Dysmenorrhea Headache Sinus congestion Constipation Excess weight in the pelvis Lower back [americandragon.com]

    A woman with parametritis can experience the following signs and symptoms: Fever Pelvic and/or lower abdominal pain Back pain Pain radiating down the leg Vaginal discharge Pain during intercourse The inflammation can become chronic and in long-standing [fertilitysmarts.com]

    […] differential Imaging: Abdominal Ultrasound (assess for urinary retention) Pyelonephritis – symptoms usually persist for Sx: Dysuria, hematuria, flank pain, abdominal pain, fever, urinary urgency/frequency, nausea, vomiting Labs: Leukocytosis with left [clinicaladvisor.com]

    It is characterized by fever, uterine subinvolution, chills and sweats, abdominal pain that spreads laterally, and, if untreated, the formation of a large abscess and signs of peritonitis. [medical-dictionary.thefreedictionary.com]

  • Constipation

    Long delay of defecation causes constipation and hardened feces. 排粪时胸肌、膈肌、腹壁肌及盆膈肌收缩,均压迫消化管。若便意持续受到抑制,粪便即变得干硬。 Two-winged species have only the pectoral fins enlarged; four-winged species have both the pectoral and the pelvic fins enlarged. [hujiang.com]

    […] rash Headache Acne Chills High fever Restlessness Urticaria Sore throat Swelling of the throat Coughing Reddish urine Dyspnea Vertigo Severe aversion to Cold Skin rashes Skin ruptures or ulcers Tense abdomen Shoulder stiffness Numb extremities Fatigue Constipation [americandragon.com]

    A meta-analysis found tegaserod to have significant benefits in women with constipation-predominant IBS. [emedicine.medscape.com]

    Patients on prolonged bedrest should be given heparin to prevent deep venous thrombosis as well as stool softeners to prevent constipation. [medical-dictionary.thefreedictionary.com]

    The latter had superior pain relief at 12 months; however, 94% of patients complained of constipation following LPSN compared to 0% in the LUNA group. [www1.cgmh.org.tw]

  • Diarrhea

    […] or "cock crow" diarrhea T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow Treatment Principle Warm the Kidneys Drain Dampness Herb Formulas Points Clinical Manifestations Localized painful swellings without a head that bleed into [americandragon.com]

    You may have: Swollen belly Diarrhea Fever or chills Lack of appetite and possible weight loss Nausea or vomiting Weakness Cough Your symptoms can be a sign of many different problems. [medlineplus.gov]

    Loperamide was also found to be useful for women with painless diarrhea. It is now available on the US market. [emedicine.medscape.com]

    Vomiting and diarrhea are common, and multiple organ system dysfunction with rapid progression to hypotension and shock can be seen in severe cases. [glowm.com]

  • Rectal Pain

    Endometriosis: Sx: Pelvic pain, dysmenorrhea, dyspareunia, rectal pain with bleeding (if bowel invasion) Labs: CBC (blood loss anemia) Imaging: Ultrasound is of limited value since cysts cannot be differentiated from neoplasm. [clinicaladvisor.com]

  • Dyschezia

    Patients experience generalized lower abdominal tenderness, and associated complaints include dysmenorrhea, dyschezia, and dyspareunia. [www1.cgmh.org.tw]

Skin

  • Skin Tenderness

    The skin normally has many types of bacteria living on it, but intact skin is an effective barrier that keeps these bacteria from entering and growing within the body. [americandragon.com]

  • Urticaria

    […] infection Thick, sticky nasal discharge and saliva Bitter taste in the mouth Dry mouth Focal distention in the chest and diaphragm Stifling sensation in the chest and diaphragm Manic behavior Carbuncles Heat rash Headache Acne Chills High fever Restlessness Urticaria [americandragon.com]

Musculoskeletal

  • Fracture

    Identification of a fracture line through the testis is uncommon, but manifests as an avascular linear or curvilinear hypoechoic defect on US (Figure 15). The presence of a fracture line does not necessarily imply rupture of the testis. [appliedradiology.com]

    Examples include after a stroke, people in plaster casts following fractures, long-distance travel and postoperative recovery. Major surgery, especially if there was an operation on the abdomen or lower limb, is a common preventable cause. Smoking. [patient.info]

    Extra-peritoneal causes of pain include dermatologic diseases such as cellulitis, musculoskeletal causes such as pelvic bone fracture, neuropathies, and referred pain from the gonads in men. [clinicaladvisor.com]

    Intraoperative and postprocedural complications and disorders of genitourinary system, not elsewhere classified [ edit ] Excludes2: irradiation cystitis (N30.4-) postoophorectomy osteoporosis (M81.8-) postoophorectomy osteoporosis with current pathological fracture [en.wikisource.org]

  • Osteoporosis

    (M81.0-) postmenopausal osteoporosis with current pathological fracture (M80.0-) postmenopausal urethritis (N34.2) N95.0 Postmenopausal bleeding N95.1 Menopausal and female climacteric states Symptoms such as flushing, sleeplessness, headache, lack of [en.wikisource.org]

    A placebo-controlled, randomized trial showed significant improvement in patients with IC who were treated with amitriptyline. [40] Corticosteroids are not widely used because of adverse effects such as fluid retention and osteoporosis. [emedicine.medscape.com]

    Corticosteroids are not widely used because of equivocal results and side effects such as fluid retention and osteoporosis. Sodium pentosan polysulfate (Elmiron) is claimed to restore the depletion in the glycosaminoglycan (GAG) layer. [www1.cgmh.org.tw]

  • Low Back Pain

    […] that is worse with pressure Abdominal spasms and tension Immobile masses in the lower abdomen with pain and tenderness Amenorrhea with distention and pain Dysmenorrhea Headache Sinus congestion Constipation Excess weight in the pelvis Lower back ache [americandragon.com]

    low back pain, vaginal discharge, fever, rash, abnormal uterine bleeding, RUQ pain (perihepatitis) Labs: Urine Pregnancy Test, Urinalysis, NAAT/Endocervical Culture for GC/CT, STD screening (HIV, syphilis), microscopy of vaginal secretions (> 15 wbcs [clinicaladvisor.com]

  • Contusion

    For intratesticular hematoma (intact tunica albuginea, localized hematoma within an otherwise intact testis) or local tenderness (contusion), observation, rest, cold packs and analgesics are appropriate therapy. [auanet.org]

Neurologic

  • Paresis

    Paralysis, paresis or recent plaster immobilisation of the legs. Recently bedridden for three days or more, or major surgery within the previous 12 weeks, requiring general or regional anaesthesia. [patient.info]

Urogenital

  • Pelvic Pain

    Adenomyosis CHRONIC PELVIC PAIN Chronic pelvic pain is defined as continuous or intermittent pelvic pain of longer than 6 months duration. No symptoms uniquely identify genitourinary structures as a source of pelvic pain. [www1.cgmh.org.tw]

    […] on patients with endometriosis and chronic pelvic pain. [emedicine.medscape.com]

    This can lead to infertility, ectopic pregnancy, pelvic pain, abscesses, and other serious problems. PID is the most common preventable cause of infertility in the United States. [icdlist.com]

    Pelvic/Supra-Pubic Pain I. Problem/Condition. Pelvic/supra-pubic pain has a wide and varied differential diagnosis. [clinicaladvisor.com]

    The perineum may be easily overlooked during imaging examinations, but it can potentially contain numerous acute conditions in patients presenting with pelvic pain. [appliedradiology.com]

  • Cervical Motion Tenderness

    During the bimanual exam, cervical motion tenderness and adnexal tenderness are most commonly associated with pelvic inflammatory disease (salpingitis, tubo-ovarian abscess). [clinicaladvisor.com]

    Pelvic exam may reveal cervical motion tenderness that is exaggerated on the side of the tubal ectopic. Initially, a sensitive serum or urine pregnancy test should be performed. [www1.cgmh.org.tw]

  • Pelvic Pain in Women

    For more information, see Medscape Reference article Chronic Pelvic Pain in Women. [emedicine.medscape.com]

Workup

[…] frequency, urgency, dysuria), afebrile, pain with a full bladder Labs: Urinalysis, Urine Culture, Blood culture, CBC with differential, Syphilis, HIV, Endocervical culture Imaging: Abdominal Ultrasound or cystoscopy in men as it is rare and warrants workup [clinicaladvisor.com]

The diagnostic workup of a patient with suspected TSS starts with a complete physical examination to investigate signs of multiorgan involvement. A pelvic examination is performed, which includes the removal of a tampon if one is present. [glowm.com]

Microbiology

  • Chlamydia

    Failure of beta-lactam antibiotics to eradicate Chlamydia trachomatis in the endometrium despite apparent clinical cure of acute salpingitis. [link.springer.com]

    Gonorrhea and chlamydia, two sexually transmitted diseases, are the most common causes of PID. Other bacteria can also cause it. [icdlist.com]

    GI) tract: Acute diverticulitis (mild, uncomplicated), gastroenteritis, H. pylori Genital tract: Acute pelvic inflammatory disease (PID) with low or high risk of gonococcal infection, acute uncomplicated gonorrhoea, bacterial vaginosis, uncomplicated chlamydia [mims.co.uk]

    The roles of enterococci, chlamydiae, and mycoplasmas remain uncertain. Culture samples must be obtained under conditions assuring minimal vaginal contamination. [academic.oup.com]

    […] prostatitis) HIV, acute hepatitis panel, RPR, HSV, syphilis – infectious causes of pelvic inflammatory disease, salpingitis, tubo-ovarian abscess, pyelonephritis, perinephric abscess Nucleic acid amplification tests and/or endocervical cultures – GC/chlamydia [clinicaladvisor.com]

Treatment

During postoperative treatment, GnRH analogs resulted in significantly reduced pain scores in women who received treatment for 6 months. [www1.cgmh.org.tw]

Symptoms and signs include : Redness Tenderness Swelling Warmth of the affected area Pelvic Cellulitis (Parametritis) : Inflammation of the tissue adjacent to the uterus, particularly in the broad ligament Treatment Principle Herb Formulas Points Clinical [americandragon.com]

Treatment The following treatments are commonly recommended for cellulitis: Medication Cellulitis nearly always responds rapidly to antibiotics. [medicalnewstoday.com]

Early treatment is important. Waiting too long increases the risk of infertility. [icdlist.com]

A review of prescribed treatments in the IC database revealed that cystoscopy with hydrodistension is the most popular treatment. [emedicine.medscape.com]

Prognosis

Thrombosis of the iliofemoral veins carries a worse prognosis with increased incidence of late clinical complications such as post-thrombotic syndrome [ 15 ]. [patient.info]

Prognosis Over 90% of all cellulitis cases are cured after seven to ten days of antibiotic treatment. [encyclopedia.com]

Etiology

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

ETIOLOGY:- •The infection gains access following: •Delivery and abortion through placental site or from lacerations of the cervix, vaginal vault or lower uterine segment. [slideshare.net]

Polymicrobial etiology of acute pelvic inflammatory disease. New England Journal of Medicine 293: 166–171, 1975 PubMed CrossRef Google Scholar Ledger WJ. Selection of antimicrobial agents for treatment of infections of the female genital tract. [link.springer.com]

See: illustration ; necrotizing fasciitis Etiology Bacteria gain access through breaks in the skin and spread rapidly, overwhelming normal body defenses; lesions between the toes from athlete's foot are common entry sites. [medical-dictionary.thefreedictionary.com]

Myofascial Pain Myofascial etiologies occur in 15% of patients with chronic pelvic pain. [emedicine.medscape.com]

Epidemiology

System(s) affected: reproductive Synonym(s): postpartum infection; endometritis; endoparametritis; endomyometritis; myometritis; endomyoparametritis; metritis; metritis with pelvic cellulitis Epidemiology Incidence Occurs in women of childbearing years [unboundmedicine.com]

Epidemiology DVT has an annual incidence of about 1 in 1,000 people [ 3 ]. [patient.info]

“Sexually transmitted diseases, pelvic inflammatory disease, and infertility: an epidemiologic update”. Epidemiol Rev. vol. 12. 1990. pp. 199-220. Donaldson, CK. “Acute Gynecologic Disorders”. Radiol Clin North Am. vol. 53. 2015 Nov. pp. 1293-307. [clinicaladvisor.com]

Pathophysiology

Fifth leading cause of maternal mortality, accounting for 11% of maternal deaths Etiology and Pathophysiology Endometritis is more common in labors complicated by chorioamnionitis. [unboundmedicine.com]

The pathophysiology of SPT is outlined by Virchow's triad: Venous stasis Injury to the vascular epithelium A hypercoagulable state These factors explain why SPT is almost always a puerperal event that is most commonly diagnosed after postcesarean endomyometritis [glowm.com]

“Sleisenger & Fordtran's Gastrointestinal and liver disease: pathophysiology, diagnosis, management”. 2010. Copyright © 2017, 2013 Decision Support in Medicine, LLC. All rights reserved. [clinicaladvisor.com]

Prevention

/Avoidable - 50% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis of Alcohol 0% Unclassified 0% We Could [medicbind.com]

PID is the most common preventable cause of infertility in the United States. Gonorrhea and chlamydia, two sexually transmitted diseases, are the most common causes of PID. Other bacteria can also cause it. [icdlist.com]

Practice Good Hygiene Keeping the skin clean and improving circulation (blood flow) to the skin are important for preventing infections. [draxe.com]

Can cellulitis be prevented? To prevent cellulitis, avoid skin breaks by wearing appropriate protective equipment when participating in risky work or sports. Keep any skin breaks clean and watch for redness, pain or other signs of infection. [mediclinicinfohub.co.za]

Prevention To prevent cellulitis, avoid skin breaks by wearing appropriate protective equipment when participating in risky work or sports. Keep any skin breaks clean and watch for redness, pain or other signs of infection. [health24.com]

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