Acute pelvic inflammatory disease: current concepts of pathogenesis, etiology and management.
Acute pelvic inflammatory disease (PID) is most common in sexually active women in their 20's; its main pathology is salpingitis. Symptoms are pain, bleeding, fever, and vaginal discharge. Gonorrhea is often involved, and N. Gonorrhoeae is responsible for the infection in women who show a positive culture for it. Anaerobic bacteria may be responsible for nongonococcal PID. Predisposing factors are previous gonorrhea and use of the IUD. Sexual transmission plays a role even in nongonococcal PID. The treatment of choice is antibiotics (penicillin, ampicillin, or tetracycline). Surgical exploration (by laparoscopy, if done at all) is not indicated except in cases of suspected surgical emergency or pelvic abscess, or failure to respond to antibiotic treatment. 80% of PID patients are free of symptoms for 2 years after treatment.