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Pelvic Inflammatory Disease

Pelvic Inflammatory Disease or PID, is a bacterial infection of the upper female genital tract, including the uterus, fallopian tubes and ovaries.

PID can be caused by several different aerobic (oxygen requiring) and anaerobic (non-oxygen-requiring) bacteria. The two most important are the bacteria which cause Chlamydia and gonorrhea. These bacteria are usually transmitted through sexual intercourse with an infected partner.

The usual symptoms of acute PID are fever, chills, lower abdominal and pelvic pain, and vaginal discharge or bleeding. These symptoms often begin a few days after the start of your period, particularly when a STD is the cause of infection.

Infections due to Chlamydia usually progress more slowly than those caused by gonorrhea. On physical examination by a doctor, the uterus, ovaries, and fallopian tubes of the infected person are usually tender.

Complications from PID occur in one out of four infected women and include tuboovarian abscess, (inflammation surrounding the liver), chronic pelvic pain, and occasionally death. In addition, PID is the single most important risk factor for ectopic pregnancy and one of the most common causes of female infertility.

A doctor, the presence of an elevated white-blood-cell count, and a positive bacterial culture of the cervical discharge usually diagnose PID on the basis of existing symptoms, physical examination.

In some instances, PID may be confused with other illnesses, such as appendicitis and a twisted or ruptured ovarian cyst. In these situations, laparoscopy may be necessary to make the correct diagnosis. Laparoscopy is a procedure where a fiber-optic telescope is placed through a small incision made beneath the navel, enabling the doctor to view the infected pelvic organs. Ultrasound may also be used to identify a pelvic abscess.

The usual treatment for PID is antibiotics. Most women take oral antibiotics such as intramuscular ceftriaxone, and oral doxycycline and metronidazole for a period of 10 to 14 days, after which they are cured. Women who are severely ill are usually treated with intravenous antibiotic therapy in the hospital. A woman's sexual partner should also be treated with antibiotics.

Because the potential complications of PID are so dangerous, preventing its onset is of great importance. Barrier contraception with spermicidal foam and condoms provides some protection against the infectious organisms that cause PID



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