Pelvic
Inflammatory Disease (PID)
Epidemiology and Etiology:
- Infection by one
or more of the following:
- Gonococci
- Chlamydiae
- Enteric bacteria
- Post-traumatic
(spontaneous or induced abortions, D&Cs,
deliveries):
- Polymicrobial (staph,
strep, coliform, Clostridium perfringens)
Common sites:
- Gonococcus:
- Bartholin glands and other vestibular glands
- Cervix
- tubes
- (Uterus usually
spared)
Gross features:
- hyperemic tubal serosa and fimbriae with layers of fibrin
- lumen filled with
purulent exudates (pyosalpinx)
- hydrosalpinx when infection resolved
- over time fimbriae may seal or plaster against the ovary
- tubo-ovarian abscess may be present
Histologic features:
- acute suppurative inflammation in superficial mucosa and submucosa
- adhesions of tubal mucosa may form gland-like spaces (follicular salpingitis)
- gonococcus:
- intracellular
gram-negative diplococcus
- satph, strep, other puerperal infections:
- more
involvement of deeper layers
- less
luminal exudation
- less involvement
of mucosa
Immunophenotype:
Marker:
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Sensitivity:
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Specificity:
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Molecular features:
Other features:
- clinical:
- pelvic
pain
- adnexal
tenderness
- fever
- vaginal
discharge
- complications:
- peritonitis
- intestinal
obstruction (adhesions
- bacteremia
- endocarditis
- meningitis
- suppurative arthritis
- infertility
References: