polymicrobial infection of the upper genital tract which is normally sterile.
PID is typically preceded by cervicitis due to Neisseria gonorrhoeae or Chlamydia trachomatis can be asymptomatic or subtle (eg, irregular intermenstrual bleeding). Untreated cervicitis allows polymicrobial vaginal flora to ascend into the upper reproductive tract (eg, uterus, fallopian tubes)
| Symptoms | • Lower abdominal pain • Abnormal bleeding | | --- | --- | | Risk factors | • Multiple sexual partners • Age 15-25 • Previous pelvic inflammatory disease • Inconsistent barrier contraception use • Partner with sexually transmitted infection | | Physical examination | • Fever >38.3 C (>100.9 F) • Cervical motion, uterine, or adnexal tenderness • Mucopurulent cervical discharge | | Diagnosis | • Clinical • | | Treatment | • Inpatient: IV broad-spectrum antibiotics • Outpatient: PO broad-spectrum antibiotics | | Complications | • Tuboovarian abscess • Infertility • Ectopic pregnancy • Perihepatitis |
intermenstrual spotting and lower abdominal pain
initially have intermittent pain; however, as infection and inflammation spread throughout the peritoneal cavity, constant pelvic pain (eg, uterine, bilateral adnexal tenderness) develops.
Uncommon during the third trimester of pregnancy, as thickened cervical mucus provides protection to the uterus from lower pelvic pathogens is more likely in nonpregnant or first-trimester patients.