The most common etiologic agents are Neisseria gonorrhea and Chlamydia trachomatis. Rapid diagnosis and treatment are important to prevent the development of recurrent infections, chronic pain, infertility, ectopic pregnancy, and peritonitis. Epidemiology Risk factors include young age, poor contraceptive habits, and many sexual partners. Teenagers are much more susceptible because the epithelium of the vagina and cervix at this age, have more columnar epithelium which allows the infective organism to ascend the genital tract after attaching to the epithelium. Untreated, the infection spreads to the fallopian tubes and a tubo-ovarian abscess forms.
Most common presentation is lower abdominal pain.
May also have dysuria, dysmenorrhea, irregular uterine bleeding. and dyspareunia. Gonorrhea infections present often with acute symptoms of fever, nausea, vomiting, vaginal discharge and peritoneal signs. This is the reason for the higher incidence of infertility following Chlamydia PID compared to Gonorrheal disease. CDC criteria for the Diagnosis of PID Minimum criteria- treatment should be initiated in the absence of other established causes of the following symptoms. Diagnosis Physical findings including pelvic examination Document GC or Chlamydial infection.