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Acute Pelvic Inflammatory Disease

 Syn. Acute PID

Signs & Symptoms

 Abdominal tenderness
Ref: Uptodate [ Pelvic inflammatory disease: Clinical manifestations and diagnosis]
Pelvic pain
Ref: Uptodate [ Acute uncomplicated cystitis in women]
Lower abdominal tenderness
Ref: Uptodate [ Pelvic inflammatory disease: Clinical manifestations and diagnosis]
Lower abdominal pain
Ref: Uptodate [ Pelvic inflammatory disease: Clinical manifestations and diagnosis] Epocrates [ https://online.epocrates.com/diseases/19533/Pelvic-inflammatory-disease/History-Exam]

Physical Examination

 Abdominal tenderness
Ref: Uptodate [ Pelvic inflammatory disease: Clinical manifestations and diagnosis]
Lower abdominal tenderness
Ref: Uptodate [ Pelvic inflammatory disease: Clinical manifestations and diagnosis]
Mucopurulent endocervical discharge
Ref: Uptodate [ Acute uncomplicated cystitis in women]

Lab / Serology

 Elevated vaginal secretions WBC
Note: eg, >15 to 20 WBCs per high power field or more WBCs than epithelial cells
Ref: Uptodate [ Pelvic inflammatory disease: Clinical manifestations and diagnosis]
Elevated C-reactive protein
Ref: Uptodate [ Pelvic inflammatory disease: Clinical manifestations and diagnosis]
Elevated erythrocyte sedimentation rate
Ref: Uptodate [ Pelvic inflammatory disease: Clinical manifestations and diagnosis]

Imagin Study

 Free pelvic fluid
Ref: Uptodate [ Pelvic inflammatory disease: Clinical manifestations and diagnosis]
Thickened fluid-filled tubes
Ref: Uptodate [ Pelvic inflammatory disease: Clinical manifestations and diagnosis]

Complication

 Fever #severe_PID
Ref: Uptodate [ Acute uncomplicated cystitis in women] Epocrates [ https://online.epocrates.com/diseases/19533/Pelvic-inflammatory-disease/History-Exam]
Decreased bowel sounds #severe_PID
Ref: Uptodate [ Pelvic inflammatory disease: Clinical manifestations and diagnosis]
Tuboovarian abscess
Ref: Uptodate [ Acute appendicitis in adults: Clinical manifestations and diagnosis]

Risk Factors

 Bacterial vaginosis
Ref: Uptodate [ Clinical features and diagnosis of pelvic inflammatory disease]
Intrauterine device
Ref: Uptodate [ Clinical features and diagnosis of pelvic inflammatory disease]
Pelvic inflammatory disease
Ref: Uptodate [ Clinical features and diagnosis of pelvic inflammatory disease]

Cause

Other