PID

Question 1

What is PID?

Answer 1

Pelvic inflammatory disease - infection of the upper genital tract

Question 2

Causes of PID?

Answer 2

Ascending infections from endocervix - STIs, postpartum, uterine instrumentation
Descend from infected organs - appendicitis
Chlamydia/ gonorrhoea
Anaerobes/ endogenous bacteria

Question 3

Symptoms of PID?

Answer 3

Lower abdo pain 
Dyspareunia 
Vaginal discharge 
Intermenstrual/ post coital bleeding 
Cervical motion tenderness

Question 4

Investigations for PID?

Answer 4

Vulvovaginal/ endocervical swabs - chlamydia and gonorrhoea
FBC and CPR ( increased WBC)
Blood culture if sepsis

Question 5

Management of PID if patient well?

Answer 5

Ceftriaxone/ azithromycin plus doxycycline and metronidazole for 14 days

Question 6

Treatment of PID if severe ?

Answer 6

Inpatient

Ceftriaxone and doxycycline (IV) followed by oral doxycycline and metronidazole for 14 days

Question 7

Complications of PID?

Answer 7

Tubo-ovarian abscess
Fitz-hugh-Curtis syndrome
Recurrent PID
Ectopic pregnancy
Subfertility from tubal blockage