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Pelvic Inflammatory Disease

Pelvic inflammatory disease refers most commonly to a bacterial infection of the fallopian tubes. The fallopian tubes are paired structures that connect each ovary to the uterus (womb). The egg is conveyed monthly via the fallopian tube to the uterus in the process of ovulation.

Bacterial infection of the fallopian tubes results most commonly from bacteria acquired through sexual contact (venereal disease). Two of the most common infecting agents are gonorrhea and chlamydia. Repeated infections may result in scarring of the fallopian tubes and infertility.

Symptoms:

  • Sudden onset of lower abdominal and pelvic pain (that may coincide with menstruation)
  • Smelly vaginal discharge
  • Pelvic pain that is made worse with sexual intercourse

More severe pelvic infections are associated with fever, chills and vomiting.

Diagnosis:

  • Evaluation will include history and physical examination.
  • The evaluation of lower abdominal pain in the female of reproductive age should always include pelvic examination to lessen the possibility of confusing the diagnosis of PID with appendicitis.
  • Vaginal cultures are a matter of routine.
  • A blood pregnancy test and blood counts are necessary in most cases.
  • Pelvic ultrasound has proven to be an excellent tool in the evaluation of a possible ovarian cyst, tubal pregnancy or fallopian tube abscess (localised collection of pus in the tube secondary to pelvic inflammatory disease).

Treatment:

Treatment of pelvic inflammatory disease requires the use of both injectable antibiotics, followed by orally administered antibiotics for 10-14 days. Sexual partners must also be treated or recurrence is likely.

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