A case of massive exudative hemorrhagic ascites occurring as a serious complication of chronic pelvic inflammatory disease (PID) is presented. The clinical manifestations, simulating diffuse carcinomatosis in a young female patient, are described. [ncbi.nlm.nih.gov]

And early presentation for the diagnosis and treatment of pelvic pain should be a key message of all sexual health promotion programs. [theconversation.com]

For example, the bacteria that are normally present in a healthy vagina can multiply and cause an infection. The exact cause of this is not completely known. [ic.steadyhealth.com]

Classic Presentation Women typically present with bilateral lower abdominal pain, purulent vaginal discharge, or less frequently with abnormal vaginal bleeding. [saem.org]

• Reiter Syndrome

  Three (2.36%) had Reiter's syndrome, 2 (1.57%) conjugal melasma and 1 (0.79%) each had primary and secondary infertility. Melasma was found in only 4 (3.15%) cases during pregnancy and in one with history suggestive of antepartum PID. [ijdvl.com]

  Reiter's syndrome (reactive arthritis). In pregnancy: PID is associated with an increase in preterm delivery, and maternal and fetal morbidity. Neonatal: perinatal transmission of C. trachomatis or N. gonorrhoeae can cause ophthalmia neonatorum. [patient.info]

• Aspiration

  The four overarching themes were: (1) the patients' characteristics, including pregnancy aspiration and the fear of serious gynecological disease; (2) the patient-practitioner relationship, including the acupuncturist's attitude towards the patients and [ncbi.nlm.nih.gov]

  If an abscess is present, pus can be aspirated with a syringe and needle. If the abscess is removed, a section of the abscess wall should be sent for culture. [glowm.com]

  Mechanical drainage of the abscess through open surgery, laparoscopy, or aspiration through a large bore needle is likely to work by removing infected material which antibiotics are unable to treat (Workowski 2015). [cochranelibrary.com]

• Sighing

  Support Yang Eliminate Stasis Stop pain Herb Formulas Points Clinical Manifestations Distending pain in the lower abdomen, with guarding May be distending pain in the chest and breasts Epigastric distention Anorexia Restlessness Irascibility Frequent sighing [americandragon.com]

• Abdominal Pain

  BACKGROUND AND OBJECTIVES: Both irritable bowel syndrome and some gynaecological diseases can give rise to lower abdominal pain, which may result in diagnostic confusion. [ncbi.nlm.nih.gov]

  […] eyes Dry mouth Anorexia Infertility Abdominal pain Anxiety Spontaneous sweating or night sweats with fever Dry eyes Hypochondriac pain Anorexia Somnolence Insomnia Aching shoulders Five sole Heat Earache Premenstrual tension Hot flashes Fatigue Lassitude [americandragon.com]

  Those symptoms may include fever, foul-smelling vaginal discharge, pain or burning during intercourse or urination, irregular menstrual periods and abdominal pain and cramps. [ic.steadyhealth.com]

  Both international and national guidelines encourage doctors to treat for PID when a woman presents with lower abdominal pain and all other causes have been excluded. [theconversation.com]

  Tags: abdominal pain chronic recurrent abdominal pain dysuria Ovarian Torsion sexual transmitted disease Sean M. Fox I enjoy taking care of patients and I finding it endlessly rewarding to help train others to do the same. [pedemmorsels.com]

• Palpitations

  […] medicinal douches or enemas, medicinal poultices or physical therapy to enhance therapeutic effects Treatment Principle Herb Formulas Points Clinical Manifestations Irritability Short temper Restlessness Fever or tidal fever Red eyes Dry mouth and throat Palpitations [americandragon.com]

  The diagnosis for PID is made basing on a physical exam, comprising of abdomen palpitation and internal or pelvic exam, during which the doctor will look for abnormal vaginal discharge, abscesses near or on ovaries or tubes, as well as pain or tenderness [ic.steadyhealth.com]

• Tinnitus

  Aching weakness in the waist and knees Dizziness Tinnitus Aversion to Cold Cold limbs Polyuria Nocturia Loose stools T: Pale C: White and smooth P: Deep and feeble Treatment Principle Warm the Kidneys Support Yang Eliminate Stasis Stop pain Herb Formulas [americandragon.com]

• Blurred Vision

  vision Heart palpitations Insomnia Dry constipation A sallow complexion T: Pale C: Scanty P: Thready and forceless Treatment Principle Generate Blood Nourish the Nutritive Level Eliminate Stasis Stop pain Herb Formulas Points Clinical Manifestations [americandragon.com]

• Dry Eyes

  eyes Hypochondriac pain Anorexia Somnolence Insomnia Aching shoulders Five sole Heat Earache Premenstrual tension Hot flashes Fatigue Lassitude Depression Restlessness Constipation with flushing up Pale complexion Bitter taste in mouth Vertigo Abdominal [americandragon.com]

• Flushing

  […] pain Anxiety Spontaneous sweating or night sweats with fever Dry eyes Hypochondriac pain Anorexia Somnolence Insomnia Aching shoulders Five sole Heat Earache Premenstrual tension Hot flashes Fatigue Lassitude Depression Restlessness Constipation with flushing [americandragon.com]

  Douching increases the risk for PID because it destroys the protective normal flora of the vagina, and it could flush bacteria up into the uterus. Risk of reoccurrence of PID is possible with the use of latex condoms. [medical-dictionary.thefreedictionary.com]

• Subcutaneous Nodule

  Secondary outcomes include the recurrence rate and side effects, such as pneumothorax, bleeding, serious discomfort, subcutaneous nodules, and infection. [ncbi.nlm.nih.gov]

• Chloasma

  Chloasma, oral contraceptives, and plasma b-melanocytic-stimulating-hormone. J Inves Dermatol 1977;68:169-70. [ PUBMED ] 7. Sawhney MPS. Chronic actinic dermopathy - A clinical study in Ladakh. Indian J Dermatol Venereol Leprol 2002;68:38-9. 8. [ijdvl.com]

• Photosensitivity

  This study highlights that melasma in women is possibly due to photosensitivity in patients with chronic PID in a majority of cases. [ijdvl.com]

• Epistaxis

  Somnolence Insomnia Aching shoulders Five sole Heat Earache Premenstrual tension Hot flashes Fatigue Lassitude Depression Restlessness Constipation with flushing up Pale complexion Bitter taste in mouth Vertigo Abdominal distention near the umbilicus Epistaxis [americandragon.com]

• Fear

  The four overarching themes were: (1) the patients' characteristics, including pregnancy aspiration and the fear of serious gynecological disease; (2) the patient-practitioner relationship, including the acupuncturist's attitude towards the patients and [ncbi.nlm.nih.gov]

  We found being diagnosed with PID was a distressing experience for most women, with fears focused mostly on future fertility. Infertility worries influenced the way women viewed themselves. [theconversation.com]

• Somnolence

  […] instability Red face Thirst Turbid urine Alternating chills and fever Red cheeks Wheezing Nervousness Headache Red eyes Dry mouth Anorexia Infertility Abdominal pain Anxiety Spontaneous sweating or night sweats with fever Dry eyes Hypochondriac pain Anorexia Somnolence [americandragon.com]

• Vertigo

  […] with fever Dry eyes Hypochondriac pain Anorexia Somnolence Insomnia Aching shoulders Five sole Heat Earache Premenstrual tension Hot flashes Fatigue Lassitude Depression Restlessness Constipation with flushing up Pale complexion Bitter taste in mouth Vertigo [americandragon.com]

• Pelvic Pain

  METHODS: A literature search will be conducted electronically with date up to October 2018 in MEDLINE, Cochrane Library, EBASE, and CNKI databases, using combination subject terms of chronic pelvic pain (or chronic pelvic inflammation, and chronic pelvic [ncbi.nlm.nih.gov]

  And early presentation for the diagnosis and treatment of pelvic pain should be a key message of all sexual health promotion programs. [theconversation.com]

  Haggerty CL, Schulz R, Ness RB (2003) Lower Quality of Life Among Women With Chronic Pelvic Pain After Pelvic Inflammatory Disease. Obstet Gynecol 102:934–939 Google Scholar 6. [link.springer.com]

• Adnexal Tenderness

  The most common physical exam findings are bilateral adnexal tenderness and purulent cervical discharge. Cervical motion, uterine, and lower abdominal tenderness may also be present. [saem.org]

  Tenderness The following add support for the diagnosis: Fever ( 101 F / 38.3 C) Mucopurulent cervical discharge or friability Wet prep with abundant WBC We always consider: Chlamydia trachomatis Neisseria gonorrhea Rates of these two being the primary [pedemmorsels.com]

  Sensitivity of clinical diagnosis PID was improved when the patient had adnexal tenderness on exam.) Westrom, L, Joesoef, R, Reynolds, G, Hagdu, A, Thompson, SE. “Pelvic inflammatory disease and fertility. [clinicaladvisor.com]

  Pelvic inflammatory disease should be suspected in at risk patients who present with pelvic or lower abdominal pain with no identified etiology, and who have cervical motion, uterine, or adnexal tenderness. [aafp.org]

• Dyspareunia

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

  The woman usually presents with symptoms of pelvic pain, heavy and painful menstrual periods, pain with intercourse (dyspareunia) and/or infertility that triggers an evaluation that reveals extensive pelvic scar tissue. [haveababy.com]

  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]

  […] unexplained and untreated abdominal pain are significantly more likely to have tubal infertility than women without such history; therefore caution should be used in dismissing mild symptoms (mild non-specific abdominal pain, vaginal discharge, bleeding or dyspareunia [pedsinreview.aappublications.org]

  Other causes of dyspareunia - eg, endometriosis. Investigations Pregnancy test (pregnant women with PID should be admitted; ectopic pregnancy may be confused with PID). [patient.info]

• Pelvic Pain in Women

  Repeated episodes of PID can result in scarring of the Fallopian tubes, which can lead to infertility, ectopic (tubal) pregnancy, or chronic (long-term) pelvic pain. Among women who have had PID, 1 in 8 have difficulties getting pregnant. [my.clevelandclinic.org]

  Long-term pelvic pain Some women with PID develop long-term (chronic) pain around their pelvis and lower abdomen, which can be difficult to live with and lead to further problems, such as depression and difficulty sleeping (insomnia). [nhs.uk]

  This damage can lead to serious health problems such as infertility (unable to have children) or chronic pelvic pain. Some women may even experience ectopic pregnancies (pregnancies outside of the womb). [bphc.org]

• Abdominal Pain with Urination

  pain Difficult urination Painful urination Increased menstrual flow Uterine bleeding Early menstruation Aching in limbs Dizziness Mental instability Red face Thirst Turbid urine Alternating chills and fever Red cheeks Wheezing Nervousness Headache Red [americandragon.com]

Diagnostic Work-up for Pelvic Inflammatory Disease The threshold to diagnose PID should be low to avoid possible complications, yet several diagnostic workup studies have been evaluated to improve the certainty of the diagnosis. [lecturio.com]

A thermal dosage treatment lasting between 20 and 30 minutes (for each half of the cross-fire technique treatment) was administered. At the beginning of every treatment session, the patient rated her pain perception on a 10-point ratio scale. [ncbi.nlm.nih.gov]

In the early stages the emphasis of treatment is to eliminate the exogenous pathogenic evil. In the later stages the emphasis shifts to restoring or augmenting genuine Qi. [americandragon.com]

And early presentation for the diagnosis and treatment of pelvic pain should be a key message of all sexual health promotion programs. [theconversation.com]

Prognosis of pelvic inflammatory disease The prognosis of PID depends mostly on the awareness of adolescents to look for timely health care and to prevent future episodes of sexually-transmitted infections. [news-medical.net]

[…] 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]

What Is the Prognosis? Antibiotic treatment successfully resolves most PID infections. [healthychildren.org]

Prognosis and outcome Prognosis and Outcome Approximately 25% of patients diagnosed with acute PID develop long-term sequelae. The risk for sequelae is increased if the patient has recurrent episodes of PID. [clinicaladvisor.com]

BACKGROUND: Chronic pelvic inflammation disease (PID) is a difficult-to-treat gynecological disorder with complex etiologies. Acupuncture has been applied widely for treating chronic pelvic inflammation or chronic pelvic pain symptoms in China. [ncbi.nlm.nih.gov]

Eschenbach DA, Buchanan T, Pollock HM et al. (1975) Polymicrobial etiology of acute pelvic inflammatory disease. N Engl J Med 293:166 Google Scholar 5. [link.springer.com]

[…] concentration of b-melanocytic-stimulating-hormone in these patients and those on oral contraceptives have been found to be normal. [4], [5] Genetic factors, thyroid dysfunction, cosmetics, phototoxic and antiseizure drugs have been implicated as other etiological [ijdvl.com]

Etiology of Pelvic Inflammatory Disease Pelvic inflammatory disease is an infectious disorder. Chlamydia trachomatis and Neisseria gonorrhoeae are the two most commonly identified etiological organisms of PID. [lecturio.com]

The microbial etiology is linked to sexually transmitted microorganisms, including Chlamydia trachomatis, Neisseria gonorrheae, Mycoplasma genitalium, and bacterial vaginosis-associated microorganisms, predominantly anaerobes. [journals.lww.com]

Epidemiology and trends in the United States 1975 and 1981. JAMA 251:2529–2533 Google Scholar 13. Westrom L (1980) Incidence, prevalence and trends of acute pelvic inflammatory disease and its consequences in industrialized countries. [link.springer.com]

[…] inflammatory disease (PID) -- usually a spontaneous infection that occurs among sexually active, menstruating, nonpregnant women -- covers: pathophysiology; microbial etiology (gonorrhea, chlamydia, genital mycoplasmas, and aerobic and anerobic bacteria); epidemiology [ncbi.nlm.nih.gov]

Objectives After completing this article, readers should be able to: Describe the epidemiology and pathogenesis of pelvic inflammatory disease (PID). Recognize the clinical features of PID. [pedsinreview.aappublications.org]

Epidemiology of Pelvic Inflammatory Disease Pelvic inflammatory disease is a common condition in the United States and approximately 2.5 million women develop PID per year. Up to 150,000 patients are hospitalized per year because of PID. [lecturio.com]

Sexually transmitted diseases, pelvic inflammatory disease, and infertility: an epidemiologic update. Epidemiol Rev. 1990;12:199-220. Cates W Jr, Wasserheit JN. Genital chlamydial infections: epidemiology and reproductive sequelae. [std.uw.edu]

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]

Pathophysiology of Pelvic Inflammatory Disease PID occurs in two subsequent steps or stages. At first, the patient develops a sexually transmitted infection that is usually chlamydial and asymptomatic. [lecturio.com]

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]

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]

Pathophysiology of abscess formation. Clin Obstet Gynecol 10:93, 1983 56 Moller BR, Freundt EA, Block FT, et al. Experimental infection of the genital tract of female grivet monkeys by Mycoplasma hominis. [glowm.com]

Prompt treatment of chlamydia and gonorrhoea infections is essential for the prevention of potential PID. In Australia, rates of chlamydia and gonorrhoea diagnoses are highest among 15- to 24-year-olds. [theconversation.com]

Resources: Division of STD Prevention (DSTDP) Centers for Disease Control and Prevention - www.cdc.gov/std CDC National Prevention Information Network (NPIN) 1-800-458-5231 - www.cdcnpin.org American Sexual Health Association (ASHA) 1-800-783-9877 - www.ashastd.org [healthcenter.indiana.edu]

The cervix produces mucus that normally prevents bacteria from spreading to the upper reproductive tract. [medbroadcast.com]

How can I prevent PID? Getting tested for STDs is one of the best ways to prevent PID, because PID is usually caused by chlamydia or gonorrhea. [plannedparenthood.org]

Centers for Disease Control and Prevention. (2015). PID. Centers for Disease Control and Prevention. (2015). 2015 Sexually Transmitted Diseases Treatment Guidelines: Pelvic Inflammatory Disease (PID). [womenshealth.gov]