Pelvic inflammatory disease

Pelvic inflammatory disease (or disorder) (PID) is a generic term for infection of the female uterus, fallopian tubes, and/or ovaries as it progresses to scar formation with adhesions to nearby tissues and organs. This may lead to tissue necrosis with/or without abscess formation. Pus can be released into the peritoneum. 2/3 of patients with laparoscopic evidence of previous PID were not aware they had had PID (Cecil's 5th ed). PID is often associated with, because it is a common result of infection with, sexually transmitted diseases. PID is a vague term and can also refer to viral, or fungal, or parasitic, but usually with bacterial infections. PID should be classified by affected organs, the stage of the infection, and the organism(s) causing it. Although very commonly a sexually transmitted infection is the likely cause, other routes are possible for some agents including lymphatic, often postpartum, postabortal (either miscarriage or abortion) or IUD related, and hematogenous spread.

Prognosis

Although the PID infection itself may be cured, effects of the infection may be permanent. This makes early identification by someone who can prescribe appropriate curative treatment so important in the prevention of damage to the reproductive system. Since early gonococcal infection may be asymptomatic, regular screening of individuals at risk for common agents (history of multiple partners, history of any unprotected sex, or people with symptoms) or because of certain procedures (post pelvic operation, postpartum, miscarriage or abortion). Prevention is also very important in maintaining viable reproduction capabilities. If the initial infection is mostly in the lower tract, after treatment the person may have little difficulties. If the infection is in the fallopian tubes or ovaries, more serious complications are more likely to occur.

Treatment

Treatment depends on the cause and generally involves use of antibiotic therapy. See specific diseases for treatment. Treatment may take longer than other infections especially if an abscess has developed. Insufficient dose, wrong drug or drug resistance, or too short duration of treatment may lead to continued symptoms/infection/complications. Treating partners for STD's is a very important part of treatment and prevention. 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. Anyone with PID and partners of patients with PID should be treated for N. gonorrhoea and C. trachomatis.

Abstinence should be practiced for 7 days after a single dose treatment for chlamydia (not with PID) or until the 7 day course is completed or transmission to others could still occur.