Pelvic inflammatory disease (PID) is a common cause of pelvic pain, ectopic pregnancy, tubo-ovarian abscesses and infertility in young women (Clinical). In the United States, chlamydia and gonococcal infections account for more than two thirds of the one million cases of PID seen each year. The differential diagnosis of pelvic pain includes endometriosis, ovarian cysts, uterine fibroids, urinary tract infections, renal calculi and bowel-related conditions.
The most common cause of PID is an infection with organisms such as Chlamydia trachomatis or Nisseria gonorrhea ascending through the vagina and uterus (Clinical). These infections are usually transmitted through sexual intercourse, with chlamydia accounting for about 50 percent of these cases. In a non-genitourinary setting, one in 10 people under age 25 tested positive for chlamydia, the rates being higher in men (13.3 percent) than women (10.1 percent). Infections with other organisms such as streptococci or staphylococci can occur after a miscarriage or an abortion. Mycoplasma and ureaplasma can also cause PID.
Pelvic infection may present at some time after the initial exposure, and is often asymptomatic, allowing the inflammation to go undetected and result in serious consequences (Clinical).
Antibiotics are usually effective in the acute phase of PID from STDs, with Chlamydia responding well to a two-week course of doxycycline, or a three-day course of azithromycin, and gonorrhea responds to metronidazole and high-dose benzylpenicillin. Treatment should not be delayed because of the risk of infertility if treatment is delayed.
PID can be a consequence of the release of Escherichia coli, Streptococcus faecalis and Bacteroides from appendicitis with peritonitis, which can lead to salpingitis and abscess formation (Clinical). The right fallopian tube and ovary may be infected. Infection can be through the bloodstream, especially with tuberculosis. Pe...