Pelvic Inflammatory Disease


    • Iinfectious and inflammatory disorder of the upper female reproductive tract

Risk Factors

    • Multiple sexual partners

    • History of prior STIs

    • History of sexual abuse

    • Frequent vaginal douching

    • Younger age

    • Iatrogenic

      • Breaking cervical barrier

Differential diagnosis


    • From 1995-2001, 769,859 cases of PID were reported in the United States


    • Vaginal or cervical infection

      • Commonly Neisseria gonorrhoeae and Chlamydia trachomatis

    • Direct ascent of micro-organisms from the vagina and cervix

      • Efficacy of mucus plug?

Clinical features

    • Lower abdominal pain

        • Dull, aching or crampy, bilateral, and constant

        • Begins a few days after the onset of the last menstrual period and tends to be accentuated by motion, exercise, or coitus.

        • Pain may be exacerbated by movement or sexual activity (dyspareunia).

        • Pain from PID usually lasts less than 7 days

    • Unanticipated vaginal bleeding, often postcoital

    • Temperature higher than 38.3°C (101°F)

    • Abnormal cervical or vaginal mucopurulent discharge

    • Presence of white blood cells (WBCs) on saline microscopy of vaginal secretions

    • Elevated erythrocyte sedimentation rate

    • Elevated C-reactive protein level

    • Laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis




a) conservative

b) medical

c) surgical


    • Tubo-ovarian abscess

    • Pelvic peritonitis and Fitz-Hugh-Curtis syndrome (perihepatitis)

    • Long-term sequelae such as chronic pelvic pain and tubal infertility