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Pelvic inflammatory disease

Última revisão: 20 Aug 2025
Última atualização: 02 May 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • uterine tenderness
  • cervical motion tenderness
  • adnexal tenderness
Detalhes completos

Outros fatores diagnósticos

  • lower abdominal pain
  • abnormal cervical or vaginal discharge
  • fever
Detalhes completos

Fatores de risco

  • prior infection with chlamydia or gonorrhea
  • young age at onset of sexual activity
  • unprotected sexual intercourse with multiple sexual partners
  • prior history of PID
  • IUD use
  • smoking
  • low socioeconomic status
  • current vaginal douching
  • intercourse during menstruation
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • white blood cell count
  • polymorphonuclear cells on wet mount of vaginal secretions
  • nucleic acid amplification test for Neisseria gonorrhoeae and Chlamydia trachomatis
  • nucleic acid amplification test for Mycoplasma genitalium
Detalhes completos

Investigações a serem consideradas

  • serum erythrocyte sedimentation rate (ESR)
  • transvaginal ultrasound
  • pelvic CT
  • pelvic MRI
  • laparoscopy
  • endometrial biopsy
Detalhes completos

Algoritmo de tratamento

AGUDA

suspected or confirmed mild-to-moderate PID at initial presentation

severe PID, complications, or no response to intramuscular/oral therapy

Colaboradores

Autores

Madhavi Manoharan, MD, FRCOG

Consultant Obstetrician and Gynecologist

Integra Healthcare Ltd

Grand Cayman

Cayman Islands

Declarações

MM declares that she has no competing interests.

Agradecimentos

Dr Madhavi Manoharan would like to gratefully acknowledge Dr Dan Selo-Ojeme and Dr Susan Arjmand, previous contributors to this topic.

Declarações

DSO and SA declare that they have no competing interests.

Revisores

Bradford Fenton, MD

Physician

Department of Obstetrics and Gynecology

Summa Health System

Akron

OH

Declarações

BF declares that he has no competing interests.

Edmond Edi-Osagie, MBBS, MRCOG, MD

Consultant Gynaecologist

Central Manchester University Hospitals

St. Mary's Hospital

Manchester

UK

Declarações

EEO declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.Texto completo

Ross J, Guaschino S, Cusini M, et al. 2017 European guideline for the management of pelvic inflammatory disease. Int J STD AIDS. 2018 Feb;29(2):108-14.Texto completo  Resumo

American College of Radiology. ACR appropriateness criteria: acute pelvic pain in the reproductive age group. 2023 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
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  • Diretrizes

    • ACR appropriateness criteria: acute pelvic pain in the reproductive age group
    • European guideline on the management of Mycoplasma genitalium infections
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