Pelvic Inflammatory Disease (Deep Dive R27)

* 50% of cases of Pelvic Inflammatory Disease (PID) is caused by common STIs (Gonorrhea, Chlamydia ) but up to 50% is caused by native vaginal flora/other organisms* No SINGLE historic, physical, or laboratory finding is both sensitive and specific for the diagnosis of acute PID* Women with PID may be asymptomatic!!* Presumptive treatment of PID should be initiated for sexually active women if they are experiencing pelvic/lower abdominal pain and if…* No alternative explanation can be found to explain patient’s pain, OR* ANY one of the three following findings are discovered on pelvic examination: cervical motion tenderness, adnexal tenderness, uterine tenderness* All antibiotics used to treat PID should also be effective against Gonorrhea and Chlamydia because negative endocervical screening for these organisms do not rule out upper genital tract infection* Many antibiotic treatment combinations exist: Ceftriaxone, Doxycycline, and Metronidazole is a common regimen Further Reading: CDC STI Treatment Guidelines