289
Genital Tract Infections
and PID
Chapter 30
Lisa Jambusaria, MD
❍ What are some medical sequelae of pelvic inflammatory disease (PID)?
Increased rate of ectopic pregnancy, chronic and acute pelvic pain, and infertility.
❍ What are some common organisms causing PID?
The infection is usually polymicrobial, commonly included are Chlamydia trachomatis, Neisseria gonorrheae,
cytomegalovirus (CMV), endogenous aerobic and anaerobic bacteria, and rarely genital Mycoplasma species.
❍ N. gonorrheae and C. trachomatis coexist in the same individual in what percentage of the time?
25% to 50% of the time.
❍ What percentage of women with asymptomatic gonococcal cervical infection will develop acute salpingitis?
15%.
❍ What is the incidence of infertility with one episode of PID?
10%, and 25% with 2 and 40% to 60% with a third episode.
❍ What is Fitz-Hugh-Curtis syndrome?
Syndrome characterized by perihepatic inflammation that occurs in 5% to 10% of patients with PID, likely from
transperitoneal or vascular route of N. gonorrheae or C. trachomatis.
❍ What is the pathognomonic sign of Fitz-Hugh-Curtis syndrome?
“Violin String” like filmy scar tissue at the RUQ from the liver to the anterior abdominal wall.
❍ What is the most common nonviral sexually transmitted disease?
Chlamydia trachomatis. It is more common than Neisseria by as much as 10 to 1 in some studies.
❍ What warrants IV antibiotics or inpatient admission for findings of PID?
Tubo-ovarian abscess (TOA), hemodynamic instability, poor compliance, high fevers, and severe pain requiring
IV pain medication.