Pelvic Inflammatory Disease (=PID)
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[edit] Pelvic inflammatory disease (=PID)
PID describes an infection of the upper genital female tract, which can include any of the structures between the ovary to the cervix. This would include an infection of the ovary (called "oophoritis"), infection of the fallopian tube (="salpingitis"), infection of the uterus inside (="endometritis")and infection of the cervical canal (="cervicitis").The common bacteria that cause these infections belong into the venereal disease category as PID commonly is sexually transmitted.
On top of the causes is Neisseria gonorrhea, the bacterium responsible for gonorrhea. The other common cause is Chlamydia trachomatis. Here is an example of a woman who had a chlamydia infection that caused pelvic pain. During laparoscopy this image was taken showing a closed off swollen and tortuous right fallopian tube ( arrow pointing to it), called a "pyosalpinx". The chlamydial infection had closed off the tube as a result of scarring and inside the hollow structure pus had accumulated. This is an extremely painful condition and will leave permanent scarring and can lead to infertility problems, if it also develops on the other side.
Symptoms:
Patients with PID have a fever and lower abdominal pain. There might be a vaginal discharge and some period like bleeding between periods. The symptoms may involve abdominal pain, particularly when the fallopian tube or the ovary is involved in the infection.
This is common with gonorrhea, which very quickly can destroy the normal tissue and lead to a pelvic abscess and peritonitis. Often it leaves severe scarring behind and frequently it affects both sides. With cervicitis there is bleeding on sexual contact. A purulent discharge is evident, particularly when the doctor examines the patient. Salpingitis starts shortly after the woman's period with lower abdominal pain. When the cervix is moved when the doctor examines the patient, there is tenderness of the affected side. The clinical presentation can be very similar in symptoms to acute appendicitis and pose a diagnostic problem on the right side. If in doubt the specialist will organize a laparoscopy for diagnostic purposes.As one of the lasting effects of PID is infertility through scarring of both fallopian tubes, prompt diagnosis and treatment have to be instituted.
Treatment:
Antibiotic therapy is immediately stared, usually intravenously. This is carried on until the patient has been without a fever (=afebrile) for 24 hours. Then oral antibiotics are carried on for as long as the doctor orders. An abscess has to be drained by the gynecologist by one of the approaches (transvaginal or percutaneous) under ultrasound guidance. The sexual partner(s) of the patient should also be treated.
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References:
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