Pelvic inflammatory disease is an inflammation of the upper genital tract caused due to infection that primarily affects sexually active young women. PID is often misdiagnosed and can be asymptomatic, chronic, or acute.
Various infectious processes that damage the fallopian tubes, endometrium, pelvic peritoneum, and ovaries are included in pelvic inflammatory disease (PID). Sexually transmitted infections cause most PID cases, but organisms associated with bacterial vaginosis have also been implicated.
Epidemiology
PID most usually affects females between the ages of 15 and 25. It is estimated that sexually active women 18 to 44 years of age had a self-reported lifetime PID prevalence of 4.4%. Women with high-risk factors, such as a history of sexually transmitted illness, have the most significant rate of self-reported lifetime cases.
With no STD history, black women have a lifetime prevalence of 6% and 2.7% in white women. PID is associated with sexually transmitted diseases. Routine screening for gonorrhea and chlamydial infections is necessary to reduce the incidence of PID.
Anatomy
Pathophysiology
It is an ascending infection that develops in the lower genital tract and spreads. Inflammatory damage by an infection of the upper female genital tract causes adhesions, scarring, and a partial or complete constriction of the fallopian tubes.
As a result, the fallopian tube lining loses its ciliated epithelial cells, which could hinder ovum transfer and raise the risk of infertility and ectopic pregnancy. Adhesions can also cause persistent pelvic pain.
Etiology
PID results from an infection that rises from the cervix. The bacteria which cause the infection are transferred sexually in 85% of cases. The most prevalent pathogens among the aggravating agents are the bacterium Neisseria gonorrhoeae or Chlamydia trachomatis. 10% to 15% of women with endocervical C. trachomatis or N. gonorrhoeae eventually develop the pelvic inflammatory disease.
PID caused by gonorrhea is typically more intense than PID from other causes. Chlamydia PID is more likely to result in subclinical PID since it is less likely to produce symptoms. While subclinical PID may not show symptoms, it can have adverse long-term effects.
Certain cervical microbes, such as Mycoplasma genitalium, are assumed to be associated with this condition. Bacteroides and Peptostreptococcus species are associated with bacterial vaginosis. Respiratory pathogens such as Streptococcus pneumonia, Haemophilus influenza, and Staphylococcus aureus have been associated with cases of acute PID.
Genetics
Prognostic Factors
The disease outcome depends on prevention strategy and routine screening for women under 25 and pregnant women. Behavioral therapy is advised for adults and adolescents at high risk of sexually transmitted infections. Late treatment is profoundly related to poor outcomes and several complications.
Even with prompt treatment, long-term problems can arise. Females between the ages of 20 and 24 are 8.5% likely to have ectopic pregnancies, 18% more likely to experience chronic discomfort, and 16.8% more inclined to struggle with infertility.
1 g IM or IV given every 12hrs for mild conditions
1-2 g IM or IV every 8hrs moderate to severe infections
2 g IV every 6-8hrs high dosing for infections
2 g IV every 4hrs for life-threatening infections
12 g is the maximum dose required per day
1-2 g IV or IM was given once a day or in equally divided doses 2x a day
maximum duration of therapy is 4-14 days
prolonged treatment recommends for complicated infections
Pelvic inflammatory disease is an inflammation of the upper genital tract caused due to infection that primarily affects sexually active young women. PID is often misdiagnosed and can be asymptomatic, chronic, or acute.
Various infectious processes that damage the fallopian tubes, endometrium, pelvic peritoneum, and ovaries are included in pelvic inflammatory disease (PID). Sexually transmitted infections cause most PID cases, but organisms associated with bacterial vaginosis have also been implicated.
PID most usually affects females between the ages of 15 and 25. It is estimated that sexually active women 18 to 44 years of age had a self-reported lifetime PID prevalence of 4.4%. Women with high-risk factors, such as a history of sexually transmitted illness, have the most significant rate of self-reported lifetime cases.
With no STD history, black women have a lifetime prevalence of 6% and 2.7% in white women. PID is associated with sexually transmitted diseases. Routine screening for gonorrhea and chlamydial infections is necessary to reduce the incidence of PID.
It is an ascending infection that develops in the lower genital tract and spreads. Inflammatory damage by an infection of the upper female genital tract causes adhesions, scarring, and a partial or complete constriction of the fallopian tubes.
As a result, the fallopian tube lining loses its ciliated epithelial cells, which could hinder ovum transfer and raise the risk of infertility and ectopic pregnancy. Adhesions can also cause persistent pelvic pain.
PID results from an infection that rises from the cervix. The bacteria which cause the infection are transferred sexually in 85% of cases. The most prevalent pathogens among the aggravating agents are the bacterium Neisseria gonorrhoeae or Chlamydia trachomatis. 10% to 15% of women with endocervical C. trachomatis or N. gonorrhoeae eventually develop the pelvic inflammatory disease.
PID caused by gonorrhea is typically more intense than PID from other causes. Chlamydia PID is more likely to result in subclinical PID since it is less likely to produce symptoms. While subclinical PID may not show symptoms, it can have adverse long-term effects.
Certain cervical microbes, such as Mycoplasma genitalium, are assumed to be associated with this condition. Bacteroides and Peptostreptococcus species are associated with bacterial vaginosis. Respiratory pathogens such as Streptococcus pneumonia, Haemophilus influenza, and Staphylococcus aureus have been associated with cases of acute PID.
The disease outcome depends on prevention strategy and routine screening for women under 25 and pregnant women. Behavioral therapy is advised for adults and adolescents at high risk of sexually transmitted infections. Late treatment is profoundly related to poor outcomes and several complications.
Even with prompt treatment, long-term problems can arise. Females between the ages of 20 and 24 are 8.5% likely to have ectopic pregnancies, 18% more likely to experience chronic discomfort, and 16.8% more inclined to struggle with infertility.
1 g IM or IV given every 12hrs for mild conditions
1-2 g IM or IV every 8hrs moderate to severe infections
2 g IV every 6-8hrs high dosing for infections
2 g IV every 4hrs for life-threatening infections
12 g is the maximum dose required per day
1-2 g IV or IM was given once a day or in equally divided doses 2x a day
maximum duration of therapy is 4-14 days
prolonged treatment recommends for complicated infections
Administer 1 gram orally along with a single dose of 2 grams of cefoxitin via intramuscular injection
https://www.ncbi.nlm.nih.gov/books/NBK499959/
https://www.cdc.gov/mmwr
medtigo
Pelvic Inflammatory Disease
Updated :
September 5, 2022
Pelvic inflammatory disease is an inflammation of the upper genital tract caused due to infection that primarily affects sexually active young women. PID is often misdiagnosed and can be asymptomatic, chronic, or acute.
Various infectious processes that damage the fallopian tubes, endometrium, pelvic peritoneum, and ovaries are included in pelvic inflammatory disease (PID). Sexually transmitted infections cause most PID cases, but organisms associated with bacterial vaginosis have also been implicated.
PID most usually affects females between the ages of 15 and 25. It is estimated that sexually active women 18 to 44 years of age had a self-reported lifetime PID prevalence of 4.4%. Women with high-risk factors, such as a history of sexually transmitted illness, have the most significant rate of self-reported lifetime cases.
With no STD history, black women have a lifetime prevalence of 6% and 2.7% in white women. PID is associated with sexually transmitted diseases. Routine screening for gonorrhea and chlamydial infections is necessary to reduce the incidence of PID.
It is an ascending infection that develops in the lower genital tract and spreads. Inflammatory damage by an infection of the upper female genital tract causes adhesions, scarring, and a partial or complete constriction of the fallopian tubes.
As a result, the fallopian tube lining loses its ciliated epithelial cells, which could hinder ovum transfer and raise the risk of infertility and ectopic pregnancy. Adhesions can also cause persistent pelvic pain.
PID results from an infection that rises from the cervix. The bacteria which cause the infection are transferred sexually in 85% of cases. The most prevalent pathogens among the aggravating agents are the bacterium Neisseria gonorrhoeae or Chlamydia trachomatis. 10% to 15% of women with endocervical C. trachomatis or N. gonorrhoeae eventually develop the pelvic inflammatory disease.
PID caused by gonorrhea is typically more intense than PID from other causes. Chlamydia PID is more likely to result in subclinical PID since it is less likely to produce symptoms. While subclinical PID may not show symptoms, it can have adverse long-term effects.
Certain cervical microbes, such as Mycoplasma genitalium, are assumed to be associated with this condition. Bacteroides and Peptostreptococcus species are associated with bacterial vaginosis. Respiratory pathogens such as Streptococcus pneumonia, Haemophilus influenza, and Staphylococcus aureus have been associated with cases of acute PID.
The disease outcome depends on prevention strategy and routine screening for women under 25 and pregnant women. Behavioral therapy is advised for adults and adolescents at high risk of sexually transmitted infections. Late treatment is profoundly related to poor outcomes and several complications.
Even with prompt treatment, long-term problems can arise. Females between the ages of 20 and 24 are 8.5% likely to have ectopic pregnancies, 18% more likely to experience chronic discomfort, and 16.8% more inclined to struggle with infertility.
https://www.ncbi.nlm.nih.gov/books/NBK499959/
https://www.cdc.gov/mmwr
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