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  • Pelvic Inflammatory Disease (PID)

PELVIC INFLAMMATORY DISEASE (PID)

Causative organisms

Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium

Polymicrobial. Vaginal bacteria also implicated

Up to 70% of cases do not have identified causative organism

Note: PID in women under the age of 35 years is often due to sexually transmissible pathogens, while PID in older women is less likely to be associated with a sexually transmitted pathogen.

Incubation period Poorly defined; depends on pathogen
How far back to trace See relevant sections if chlamydia, gonorrhoea or Mycoplasma genitalium are isolated
Usual testing method Clinical diagnosis with bimanual pelvic examination Test for chlamydia, gonorrhoea and M. genitalium- swabs can be clinician or self-collected if examination declined
Common symptoms

Commonly mild or subclinical
New onset pelvic pain in women 15-25 is highly predictive
Pelvic pain can be bilateral and may worsen with movement, intermenstrual or post-coital bleeding, heavy menstrual bleeding deep dyspareunia Sometimes vaginal discharge Fever, nausea, vomiting may indicate severe infection

Likelihood of transmissio per act of unprotected intercourse Depends on specific pathogen
Likelihood of long-term sexual partner being infected Depends on specific pathogen
Protective effect of condoms High for sexually transmitted pathogens
Transmission by oral sex Unknown
Duration of potential infectivity Depends on specific pathogen
Important sequelae Infertility due to scarring /blockage of fallopian tubes Chronic pelvic pain Ectopic pregnancy Fitz-Hugh Curtis Syndrome
Direct benefit of detection and treatment of contacts Cure where a pathogen is isolated
Usual management of contacts

Counselling, clinical examination, test for C.trachomatis, N. gonorrhoeae and M. genitalium

Consider presumptively treating current sexual contacts for gonorrhoea if suspected

Contact tracing priority

High — Where C. trachomatis, N. gonorrhoeae or M. genitalium are isolated
Medium — Younger women and current male sexual partners where a sexually transmitted pathogen is not isolated
Low — Older women and previous sexual partners where a sexually transmitted pathogen is not isolated. Pelvic infection is secondary to gynaecological

Notification Not notifiable

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