Flashcards in Week 6.1 - Pelvic inflammatory disease Deck (18)
What is endometritis?
-Inflammation and infection of the endometrium resulting in plasma cell infiltration and granuloma formation
What is salpingitis?
-Inflammation and infection of the uterine tubes
Name a complication of salpingitis
How does a tubo-ovarian abscess form?
-Inflammatory exudate fills the lumen on the salpinx causing inflamamtion of the serosa and pus leaks from the tube
-Causes adhesions of the tube to the pelvic sidewall leading to blockage and further swelling of the tube with the infection confined by the omenta
Describe the pathophysiology of PID
-The infection ascends from the vagina and endocervix and causes inflammation of the tubes -> pain and damage to tubal eipthelium resulting in adhesions
Describe the aetiology of PID
-Often polymicrobial from STIs such as chlamydia, gonorrhoea, gardnerella vagialis
What are the risk factors for PID?
-Lack of barrier contraception
-Multiple sexual partners
-On insertion/removal of IUD
Outline the management of PID
-Empirical treatment for 14 days to cover all microbes involved eg ceftriaxone + doxycycline + metronidazole
-IV antibiotics or sugery for severe PID
What classifies severe PID?
-Signs of peritonitis, tubo-ovaran abscess or sepsis
When is surgical management indicated?
-When there is no response to therapy, it is clinically severe or an abscess is present
List some possible complications of PID
-Chronic pelvic pain
What is fitz-hugh-curtis syndrome?
-Rare complication of PID characterised by perihepatitis and adhesions
-Can manifest as shoulder tip pain, RUQ pain and tenderness
What is reiter syndrome?
-Disemminated chlamydial infection characterised by conjunctivitis, urethritis and arthritis
(can't see, can't pee, can't bend at the knee)
Describe the typical history of PID
-lower abdo pain
Describe what will be found on examination of PID
-Lower abdo tenderness
-cervical motion tenderness
-Cervicitis and discharge on speculum examination
Name 3 differential diagnoses of PID
What investigations are done in suspected PID?
-Bloods -> WBC and CRP