All three patients presented with an acute abdomen, fever and elevated white blood cell count. Our experience suggests that PID following tubal sterilization is more common than previously described and can present a diagnostic dilemma. [ncbi.nlm.nih.gov]

• Fever

  Treatment with colchicine for suspected familial Mediterranean fever resulted in resolution of symptoms. [ncbi.nlm.nih.gov]

  PID IUD use Iatrogenic procedures: Endometrial biopsy, Uterine curettage, Hysterosalpingography Protective Factors: Contraceptive: OCPs and Barrier methods Menopausal, pregnant with monogamous partner Symptoms: Lower abdominal and pelvic pain (dull) Fever [medchrome.com]

• Malaise

  I had severe menstrual irregularities, fevers, bleeding between periods, bleeding after intercourse, pains, and general malaise. Several times I was treated with antibiotics, which brought only some temporary relief. [ourbodiesourselves.org]

  Symptoms typically include progressive lower abdominal pain with guarding and rebound tenderness, fever, copious purulent cervical discharge, nausea and vomiting, malaise, urinary urgency and frequency, vaginal itching, and maceration. [medical-dictionary.thefreedictionary.com]

  Peritonitis, tubo‐ovarian abscess, and severe systemic illness (e.g. fever and malaise) are considered severe forms of PID; the other forms of presentation are considered mild or moderate according to the subjective opinion of the examining doctor or [cochranelibrary.com]

• Unsafe Sexual Practices

  The outcome may not be as good if individuals wait too long before treatment and/or continue to engage in unsafe sexual practices. Complications that can occur include: Tubal damage and scarring can result in infertility. [emedicinehealth.com]

  Education should concentrate on strategies to prevent PID and STIs, including reducing the number of sexual partners, avoiding unsafe sexual practices, and routinely using appropriate barrier protection. [emedicine.medscape.com]

• Atrial Septal Defect

  However, of 12 CA groups evaluated, APID was associated with a higher risk only for cardiovascular CAs (adjusted prevalence OR with 95% CI: 2.6, 1.2-5.4) and the observed number of cases with atrial septal defect, type II with maternal APID exposure exceeded [ncbi.nlm.nih.gov]

• Abdominal Pain

  An optimal set of PID indicators consisted of adnexal tenderness, lower abdominal pain of one week's duration and an elevated white blood cell count. [ncbi.nlm.nih.gov]

• Pelvic Mass

  mass (in the setting of a tuboovarian abscess), cervical excitation tenderness on bimanual examination All women presenting with symptoms and/or signs suggestive of PID should have a pregnancy test performed All women presenting with symptoms and/or [hse.ie]

  Key constituents of the physical examination include an abdominal exam (with right upper quadrant palpation), vaginal speculum exam (that includes inspection of the cervix), bimanual exam (to assess cervical motion, adnexal tenderness and pelvic masses [news-medical.net]

  For more complex cases—such as those that involve a pelvic mass, do not respond quickly to antibiotics or when the symptoms and physical exam are equivocal a laparoscopy may be necessary. [cmdrc.com]

  An abdominopelvic CT scan showed no abdominal or pelvic masses; pelvic sonography revealed normal ovaries and no free fluid. Electrolytes, white blood cell count and liver enzymes were all within normal limits; a urinalysis was negative. [austinpublishinggroup.com]

  In addition, reduction or elimination of stagnant pelvic fluids and inflammatory pelvic masses were significant as a result of acupuncture therapy. [healthcmi.com]

• Pelvic Pain

  RESULTS: Twelve (24%) women had pelvic pain for 6 months or more after hospitalization, 22 (43%) had subsequent episode(s) of pelvic inflammatory disease, and 40% were involuntarily infertile. [ncbi.nlm.nih.gov]

• Vaginal Discharge

  Variables that were good predictors of acute pelvic inflammatory disease were purulent vaginal discharge, erythrocyte sedimentation rate greater than or equal to 15 mm/hr, positive gonorrhea result, adnexal swelling on bimanual examination, and rectal [ncbi.nlm.nih.gov]

  discharge Congested external urethral meatus or openings of Bartholin’s ducts Speculum examination: Congested cervix with purulent discharge Bimanual examination: Chandelier sign: Cervical motion tenderness Adnexal tenderness Thickening or definite mass [medchrome.com]

  Most common symptom in study group was lower abdominal pain (90%), vaginal discharge (70%) and irregular bleeding (40%) and 30% patients had history of intrauterine contraceptive device (IUCD) implantation. [ijmm.org]

• Cervical Motion Tenderness

  The most frequent signs and symptoms were abnormal vaginal discharge (100%), adnexal tenderness (97.1%), cervical motion tenderness (94.3%) and fever 38.3 degrees C (82.9%). [ncbi.nlm.nih.gov]

  motion tenderness Adnexal tenderness Thickening or definite mass Minimum clinical criteria for diagnosis Cervical motion tenderness Uterine tenderness Adnexal tenderness The presence of temperature higher than 38.3 C (101 F) and abnormal cervical or [medchrome.com]

  Written assent will also be obtained from the minor) Acute PID, defined by symptoms and signs guided by current CDC guidelines:50 Current symptoms of lower abdominal or pelvic pain (present for 30 days) AND Cervical motion tenderness AND/OR uterine tenderness [clinicaltrials.gov]

  More common presentations include acute pelvic pain (of variable intensity), cervical motion tenderness, vaginal discharge, fever, dyspareunia, and leukocytosis. Right upper quadrant pain from perihepatitis in Fitz-Hugh-Curtis syndrome is possible. [radiopaedia.org]

  Fifty women in reproductive age group, who presented with atleast four of the following criteria, were included in the study: history of recurrent lower abdominal pain, presence of lower abdominal tenderness, presence of cervical motion tenderness, presence [ijmm.org]

• Adnexal Tenderness

  An optimal set of PID indicators consisted of adnexal tenderness, lower abdominal pain of one week's duration and an elevated white blood cell count. [ncbi.nlm.nih.gov]

  tenderness Thickening or definite mass Minimum clinical criteria for diagnosis Cervical motion tenderness Uterine tenderness Adnexal tenderness The presence of temperature higher than 38.3 C (101 F) and abnormal cervical or vaginal mucopurulent discharge [medchrome.com]

  tenderness on pelvic examination Ability to provide written informed consent Exclusion Criteria: Women with any of the following will be ineligible to participate: Pregnant or nursing a baby (Note: a urine pregnancy test will be done at enrollment. [clinicaltrials.gov]

• Dyspareunia

  Retrospective analysis showed that 43 of the women were given outpatient treatment for acute pelvic inflammatory disease because they had low abdominal pain, deep dyspareunia, or unusual vaginal bleeding, or all of these, for less than 2 months in association [annals.org]

  Factors: Contraceptive: OCPs and Barrier methods Menopausal, pregnant with monogamous partner Symptoms: Lower abdominal and pelvic pain (dull) Fever and chills Nausea and vomiting (indicates peritonitis) Menstrual disturbances Purulent cervical discharge Dyspareunia [medchrome.com]

  Occasionally, dyspareunia or dysuria occurs. Many women with inflammation that is severe enough to cause scarring have minimal or no symptoms. [merckmanuals.com]

  Mild symptoms include – lower abdominal/pelvic pain, deep dyspareunia, a change in vaginal discharge, post coital bleeding Severe symptoms include – all of the above and in addition there may be constitutional symptoms, shoulder tip pain, right upper [hse.ie]

  The affected women may also suffer from dyspareunia ( i.e. recurrent or persistent genital pain during or after sexual intercourse), backache and infertility. [news-medical.net]

The patient underwent extensive workup, multiple courses of intravenous and oral antibiotics, and diagnostic laparoscopies, with continued recurrent episodes. [ncbi.nlm.nih.gov]

• Ovarian Mass

  MR imaging of ovarian masses: classification and differential diagnosis. Insights Imaging. 2016:7(1):21-41. Kouijzer IJE. Initially unrecognised group A streptococcal pelvic inflammatory disease in a postmenopausal woman. Neth J Med. 2014;72:494-6. [ijrcog.org]

  Diagnoses such as ovarian masses, endometrial cancer, and colon cancer should be considered. Diagnosis There is no specific lab value, physical examination finding, or imaging study that is diagnostic of PID. [emdocs.net]

The patients were randomly assigned to two treatment groups: 16 women received ciprofloxacin 200 mg b.i.d. iv. for two days, followed by oral administration with 750 mg b.i.d. to complete a 14-day course of treatment. [ncbi.nlm.nih.gov]

This study directly documents the poor fertility prognosis for women with tubal abscess and suggests that women with culture and/or serological evidence of chlamydial infection also have a poor fertility prognosis. [ncbi.nlm.nih.gov]

Besides, our study revealed that endometriosis was related to a poor prognosis of PID and patients with endometriosis had 5.7-fold higher probability of having a poor prognosis. [omicsonline.org]

[…] become prominent due to infection draining in to lymphatics along the course of the gonadal veins MRI May show an ill-defined adnexal mass containing fluid with various signal intensities: T1 C (Gd): wall and surrounding tissues may enhance Treatment and prognosis [radiopaedia.org]

In 19 (47.5%) women, the microbial etiology could not be determined (group C). In no case was Neisseria gonorrhoeae isolated. [ncbi.nlm.nih.gov]

Both groups were compared in terms of laboratory, clinical, and epidemiological parameters. RESULTS: Of 73 patients admitted with the diagnosis of PID, 44 (60.3 %) were found to have TOA, and 29 (39.7 %) were not found. [ncbi.nlm.nih.gov]

Weström L (1986) Epidemiology of pelvic inflammatory disease. In: Ludwig H, Thomsen K (eds) Gynecology and obstetrics. Springer, New York, pp 659–661 CrossRef Google Scholar 31. Kani J, Adler MW (1992) Epidemiology of pelvic inflammatory disease. [link.springer.com]

Acinetobacter spp. as nosocomial pathogens: Epidemiology and resistance features. Saudi J Biologic Sci; 2016. [ijrcog.org]

PIP: This discussion of acute pelvic inflammatory disease (PID) -- usually a spontaneous infection that occurs among sexually active, menstruating, nonpregnant women -- covers: pathophysiology; microbial etiology (gonorrhea, chlamydia, genital mycoplasmas [ncbi.nlm.nih.gov]

Acute PID increases a woman's risk for recurrent PID, chronic pelvic pain, infertility and ectopic pregnancy. [2] Our concept of etiology and pathophysiology of acute PID has changed considerably over the past few years and as might be expected, treatment [ijmm.org]

This review paper in Obstetrics and Gynecology is an excellent up to date source for PID pathophysiology, diagnosis, treatment, and long-term outcomes.) Eschenbach, DA, Wolner-Hanssen, P, Hawes, SE, Pavletic, A, Paavonen, J, Holmes, KK. [clinicaladvisor.com]

Symptoms manifesting from these responses include an oral temperature 38.3 C (101 F), elevated erythrocyte sedimentation rate or C-reactive protein, or presence of white blood cells on microscopy of vaginal secretions. 1,2,11 Pathophysiology and Diagnosis [uspharmacist.com]

C 28, 29 Pathophysiology The microorganisms that are implicated in PID are thought to spread in three ways: Intra-abdominally, traveling from the cervix to the endometrium, through the salpinx, and into the peritoneal cavity (causing endometritis, salpingitis [aafp.org]

An intensification of educational efforts directed at IV drug-using women in San Francisco is necessary to prevent further increases in the rate of HIV infection and further spread into the heterosexual population. [ncbi.nlm.nih.gov]