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

Print Email