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13 Cards in this Set

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Who is most commonly affected by PID?

Females age 15-25

How many develop tubal infertility after PID?

>10% after one episode


50% after 3 episodes

Most is the most common cause of PID?

STI


Usually chlamydia (50%) or gonorrhoea

How does acute PID present?

Fever >38


Malaise


Acute pelvic pain, usually bilateral


Deep dyspareunia


Dysuria


Abnormal vaginal bleeding (heavier periods, intermenstrual, post-coital)


Purulent vaginal discharge

What would you see on examination for acute PID?

Pyrexia


Bilateral lower abdominal tenderness


Vaginal discharge


Cervical excitation


Adnexal tenderness

What investigations would you do for acute PID?

HVS and endocervical swab for MC&S


Chamydia/Gonorrhoea screen


Blood tests (FBC may show leukocytosis, raised CRP)

What is the management of acute PID?

Advise rest and sexual abstinence, analgesia


Treat with ofloxacin 400mg bd + metronidazole 400mg bd for 14 days


OR


Ceftriaxome 500mg IM single dose, followed by oral doxycycline 100mg bd and oral metronidazole 400mg bd for 14 days


Arrange contact tracing

What if there is no improvement of PID symptoms after 48 hours?

Admit; if slow recovery, consider referral for laparoscopy to exclude abscess formation

Who should be admitted immediately if they present with PID?

If very systemically unwell, pregnant, or if ectopic pregnancy or other acute surgical emergency cannot be excluded

How is chronic PID caused?

Inadequately treated acute PID

How does chronic PID present?

Pelvic pain


Dysmenorrhoea


Dyspareunia


Menorrhagia



What would you see on examination for chronic PID?

Lower abdominal/pelvic tenderness


Cervical excitation


Adnexal mass

What is the management of chronic PID?

Screen for chlamydia and gonorrhoea


If no obvious cause, refer to gynae


Once diagnosis confirmed, treatment options include long term antibiotics or surgery