Pelvic inflammatory disease is a polymicrobial infection or inflammatory disorders of the upper female genital tract. It occurs when sexually transmitted bacteria spread from your vagina to your uterus,fallopian tubes  and ovaries.

Causative organisms.

It is caused multiple bacteria which include;
  • N. gonorrheae(common cause)
  • C.trachmatis(common cause)
  • G. vaginalis,
  • Heamophilus influenza
  • Enteric Gram positive rodes and  streptococcus agalactie
  • Cytomegalovirus (CMV)
  • M. hominis
  • U. uealyticum and
  • M. genitalium

Signs and Symptoms of Pelvic Inflammatory Disease include:

  • Lower abdominal pains
  • Per vaginal discharge with unpleasant smell
  • Abnormal uterine bleeding, especially during or between menstrual cycles or after intercourse
  • Dyspareunia-painful intercouse and associated bleeding
  • You may experience fever or sometimes chills and
  •  Painful or difficult in micturation/urination

How to prevent Pelvic inflammatory disease.

To reduce risk of getting PID following measures should be followed.

  1. Practice safe sex. This include use of condoms every time you have sex, limit your number of partners, and ask about a potential partner’s sexual history.
  2. Talk to your doctor about contraception.Many forms of contraception do not protect against the development of PID. Using barrier methods, such as a condom, might help to reduce your risk. Even if you take birth control pills, it’s still important to use a condom every time you have sex to protect against STIs.
  3. Get tested.If you’re at risk of an STI, such as chlamydial infection, make an appointment with your doctor for testing. Set up a regular screening schedule with your doctor if needed. Early treatment of an STI gives you the best chance of avoiding spread of infection leading to PID.
  4. Request that your partner be tested.If you have pelvic inflammatory disease or an STI, advise your partner to be tested and, if necessary, treated. This can prevent the spread of STIs and possible recurrence of PID.
  5. Don’t douche.Douching upsets the balance of bacteria in your vagina.

Differential Diagnosis or what you may confuse with

  • Ectopic pregnancy
  • Acute appendicitis
  • Ovarian torsion
  • Cystitis
  • Pyelonephritis


Doctors/Clinician diagnose pelvic inflammatory disease based on signs and symptoms,

  • By performing a pelvic exam
  • An analysis of vaginal discharge and
  • Cervical swap for cultures or
  • Urine tests.

During the pelvic exam, your doctor will first check your pelvic region for signs and symptoms of PID. Your doctor might then use cotton swabs to take samples from your vagina and cervix. The samples will be analyzed at a lab to determine the organism that’s causing the infection.

To confirm the diagnosis or to determine how widespread the infection is, your doctor might recommend other tests, such as:
  • Blood and urine tests.These tests will measure your white blood cell count, which might indicate an infection, and markers that suggest inflammation. Your doctor also might recommend tests for HIV and sexually transmitted infections, which are sometimes associated with PID.
  • pelvic ultrasound.This test uses sound waves to create images of your reproductive organs.
  • Laparoscopy. During this procedure, your doctor inserts a thin, lighted instrument through a small incision in your abdomen to view your pelvic organs.


Treatments for pelvic inflammatory disease include:

  • Your doctor/clinician will prescribe a combination of antibiotics to start immediately. After receiving your lab test results, your doctor might adjust your prescription to better match what’s causing the infection. You will likely follow up with your doctor after three days to make sure the treatment is working.

Be sure to take all of your medication, even if you start to feel better after a few days. Antibiotic treatment can help prevent serious complications but can’t reverse any damage.

The following measures you should take to prevent recurency of PID
  • Treatment for your partner.To prevent reinfection with an STI, your sexual partner or partners should be examined and treated. Infected partners might not have any noticeable symptoms.
  • Temporary abstinence.Avoid sexual intercourse until treatment is completed and tests indicate that the infection has cleared in all partners.

Most women with pelvic inflammatory disease just need outpatient treatment. However, if you’re seriously ill, pregnant or haven’t responded to oral medications, you might need hospitalization. You might receive intravenous antibiotics, followed by antibiotics you take by mouth.

Surgery is rarely necessary. However, if an abscess ruptures or threatens to rupture, your doctor might drain it. You also might need surgery if you don’t respond to antibiotic treatment or have a questionable diagnosis, such as when one or more of the signs or symptoms of PID are absent.

Complication arising from untreated pelvic inflammatory disease

  • Infertility; which can be either primary or secondary infertility. This due damage to the reproductive organs such as scaring of uterus and blocked fallopian tubes.
  • Ectopic pregnancy.It is major leading cause tubal pregnancy.This due to scar in the tube that prevent egg from making it way through fallopian tube into uterus for implatation.
  • Chronic pelvic pain. This pain can last for months or years. Pain is due to scaring fallopian tubes and other pelvic related organs.
  • Tuber-ovarian abscess-this is collection of pass in uterus and ovaries.

Doc bob

Am Robert Mathenge, a healthcare provider in Nakuru county. i love this profession as it gives me chance to serve my call, interacting with people from various social backgrounds makes me feel good.

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