Özet

• Pelvic inflammatory disease is an acute ascending polymicrobial infection of the female gynaecological tract that is frequently associated with Neisseria gonorrhoeae or Chlamydia trachomatis.
• Symptoms and physical findings vary widely and may include lower abdominal tenderness, adnexal tenderness, and cervical motion tenderness. Fever and cervical or vaginal discharge may also be present.
• Diagnosis may be difficult because symptoms range from absent to severe and may be non-specific. Possible laboratory findings include abundant WBCs on saline microscopy of vaginal secretions, elevated ESR, elevated C-reactive protein, and laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis. Laparoscopy is the definitive procedure but is invasive and is not recommended for routine diagnosis.
• Antibiotic treatment should be initiated in patients who are sexually active and who have pelvic pain, cervical motion tenderness, or adnexal or uterine tenderness for which no other cause can be found. Patients may need hospitalisation and parenteral antibiotics.
• Complications include tubo-ovarian abscess and subsequent infertility or ectopic pregnancy due to scarred or obstructed fallopian tubes.