pelvic inflammatory disease

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pelvic inflammatory disease
2011-02-04 22:11:48

pelvic inflammatory disease
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  1. what is PID?
    Pelvic inflammatory disease (PID) is an infectious and inflammatory disorder of the upper female reproductive tract, including the uterus, fallopian tubes, and adjacent pelvic structures. It is a common and serious disorder, initiated by infection, that ascends from the vagina and cervix. PID may produce tubo-ovarian abscess and extend to produce pelvic peritonitis and Fitz-Hugh-Curtis syndrome
  2. pathophysiology?
    The first stage involves acquisition of a vaginal or cervical infection. The original sexually transmitted infection (STI) may be asymptomatic. An estimated 10-20% of untreated chlamydial or gonorrheal infections progress to PID. In PID, the second stage of upper female genital tract infection occurs by direct ascent of micro-organisms from the vagina and cervix.
  3. Symptoms?
    Abd pain: dull, aching or crampy, bilateral, and constant, dyspareunia, vaginal discharge/bleeding, elevated temp
  4. physical?
    lower abdominal tenderness, cervical motion tenderness, and uterine or adnexal tenderness.Mucopurulent cervicitis

    Temperature higher than 38.3°C (101°F)Abnormal cervical or vaginal mucopurulent discharge

    Presence of white blood cells (WBCs) on saline microscopy of vaginal secretions

    Elevated erythrocyte sedimentation rateElevated C-reactive protein level

    Laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis
  5. treatment
    Administer cefoxitin 2 g IV q6h or cefotetan 2 g IV q12h plus doxycycline 100 mg PO/IV q12h

    outpatient treatmentRegimen A: Administer ceftriaxone 250 mg IM once as a single dose plus doxycycline 100 mg PO bid for 14 days, with or without metronidazole 500 mg PO bid for 14 days.