Pelvic inflammatory disease
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Etiology
Epidemiology
Diagnosis
Differential diagnosis
Prognosis
Treatment
Treatment depends on the cause and generally involves use of antibiotic therapy. If the patient has not improved within two to three days after beginning treatment with the antibiotics, they should return to the hospital for further treatment. Drugs should also be given orally and/or intravaneously to the patient while in the hospital to begin treatment immediately to increase the effectiveness of antibiotic treatment. Hospitalization may be necessary if Tubo-ovarian abscess, very ill, immunodeficient, pregnancy, incompetence, or because this or something else life threatening can not be ruled out. Treating partners for STD's is a very important part of treatment and prevention. Anyone with PID and partners of patients with PID since six months prior to diagnosis should be treated to prevent reinfection. Psychotherapy is highly recommended to women diagnosed with PID as the fear of redeveloping the disease after being cured may exist. It is important for a patient to communicate any issues and/or uncertainties they may have to a doctor, especially a specialist such as a gynecologist, and in doing so, to seek follow-up care.
A systematic review of the literature related to PID treatment was performed prior to the 2006 CDC sexually transmitted diseases treatment guidelines. Strong evidence suggests that neither site nor route of antibiotic administration affects the short or long-term major outcome of women with mild or moderate disease. Data on women with severe disease was inadequate to influence the results of the study. [1]
Prevention
- Risk reduction against sexually transmitted diseases through abstinence or barrier methods such as condoms, see human sexual behavior for other listings.
- Going to the doctor immediately if symptoms of PID, sexually transmitted diseases appear, or after learning that a current or former sex partner has, or might have had a sexually transmitted disease.
- Getting regular gynecological (pelvic) exams with STD testing to screen for symptomless PID. [2]
- Discussing sexual history with a trusted physician in order to get properly screened for sexually transmitted diseases.
- Regularly scheduling STD testing with a physician and discussing which tests will be performed that session.
- Getting a STD history from your current partner and insisting they be tested and treated before intercourse.
- Understanding when a partner says that they have been STD tested they usually mean chlamydia and gonorrhea in the US, but that those are not all of the sexually transmissible diseases.
- Treating partners so you don't become reinfected or they do not infect another.
Other diseases that can lead to or be involved in PID
- Salpingitis, any infection of the fallopian tubes.
- Tubo-ovarian abscess an abscess of the fallopian tube or ovary.
- Endometritis
- Pelvic peritonitis
- The Dalkon Shield (withdrawn from the market in 1975 for this reason)
- Bacterial Vaginosis
References
- ↑ Walker CK, Wiesenfeld HC (2007). "Antibiotic therapy for acute pelvic inflammatory disease: the 2006 Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines". Clin. Infect. Dis. 44 Suppl 3: S111–22. doi:10.1086/511424. PMID 17342664.
- ↑ Smith KJ, Cook RL, Roberts MS (2007). "Time from sexually transmitted infection acquisition to pelvic inflammatory disease development: influence on the cost-effectiveness of different screening intervals". Value Health. 10 (5): 358–66. doi:10.1111/j.1524-4733.2007.00189.x. PMID 17888100.
External links
Additional Resources
- Current Obstetric & Gynecologic Diagnosis Treatment. Alan Decherney and Lauren Nathan. 9th Ed. 2003: pgs 729-731. ISBN 0-8385-1401-4
- Carpenter, Griggs, Loscalzo. Cecil's essentials of medicine 5th ed. 2001: pages 623-625. ISBN 0-7216-8179-4
- Harrison's Principles of Internal Medicine 15th ed. ISBN 0-07-007272-8