Overview

• Ascending infection of the genital tract. May affect the uterus, fallopian tubes, ovaries and the surrounding peritoneum.
• The most common causative organism is chlamydia trachomatis. (Neisseria Gonorrhoea is 2nd most common).
• Risk Factors → not using barrier contraception, multiple sexual partners, <25 years old (younger women), existing STIs, previous PID, intrauterine device (copper coil).

Making Diagnosis

Clinical Features

• Pelvic or lower abdominal pain (BILATERAL).
• Abnormal vaginal discharge.
• Abnormal bleeding → intermenstrual or postcoital.
• Dyspareunia.
• Fever.
• Dysuria.
• O/E → pelvic tenderness, cervical excitation, inflamed cervix, purulent discharge.

Investigations

• Pregnancy test → perform on any sexually active woman presenting with abdominal pain to exclude ectopic pregnancy.

• High Vaginal Swab → look for bacterial vaginosis, candidiasis and trichomoniasis.

  • Endocervical Swab → for chlamydia and gonorrhoea.

  <aside> 💡 Triple Swab → 2x endocervical + 1x high vaginal.

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• Microscope → look for pus cells on swabs from vagina or endocervix. Absence of pus cells is useful for excluding PID.