Chapter 13 – Pelvic Inflammatory Disease (PID)

Summary of chapter

Pelvic inflammatory disease (PID) is a clinical syndrome of ascending infection and inflammation from the vagina or endocervix, and may involve the endometrium, fallopian tubes, ovaries and/or peritoneum. Patients with acute disease typically present with a short history of new onset pelvic pain and dyspareunia. Untreated PID is associated with subfertility, ectopic pregnancy and chronic pelvic pain.(1, 2)

In up to 70 per cent of cases, a causative pathogen is never isolated.(1, 3) When a pathogen is identified, the sexually transmitted pathogens Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium may be implicated. PID is thought to be polymicrobial in aetiology,(1) with anaerobes and other vaginal flora also implicated in the development of disease.(2)

Negative swabs do not exclude a diagnosis of PID.

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