Pelvic Inflammatory Disease (PID) PDF

Lecture Material is adapted from © 2017 Wolters Kluwer Health, Lippincott Williams & Wilkins Applied Pathophysiology: A Conceptual Approach to the Mechanisms of Disease Chapter 14: Altered Reproductive Function Module 3: Clinical Models Copyright © 2017 Wolters Klu...

Lecture Material is adapted from © 2017 Wolters Kluwer Health, Lippincott Williams & Wilkins Applied Pathophysiology: A Conceptual Approach to the Mechanisms of Disease Chapter 14: Altered Reproductive Function Module 3: Clinical Models Copyright © 2017 Wolters Kluwer Health | Lippincott Williams &Wilkins Pelvic Inflammatory Disease (PID) McCance KL, Huether S. Pathophysiology. 7th ed. N.S.W, Mosby; 2015  Pelvic Inflammatory Disease Pathophysiology The result of a sexually transmitted infection of the reproductive tract Sexual intercourse transfers microorganisms into vagina Chlamydia Trachomatis Neisseria Gonorrhea Infection ascends Cervix > Uterus > Fallopian Tubes > Ovaries > Peritoneal cavity Microorganism trigger acute inflammation and immune response Reproductive tract: hyperemic and edematous Fallopian tubes obstructed with purulent exudate  Pelvic Inflammatory Disease Pathophysiology Repeated or chronic infection: scar formation Marieb EN, Hoehn KN. Human Anatomy & Physiology. 9th ed. Boston, Pearson Scar of fallopian tubes interferes Education; 2013 movement: Ovulation and ovum movement to uterus is prohibited Ectopic pregnancy Oocyte fertilized in peritoneal cavity or distal uterine tube begins developing there Normally abort naturally with substantial bleeding Tubo-ovarian abscess Pelvic adhesions Infertility STIs in male: Inflammation and immune response in urethra, epididymis, testes  Pelvic Inflammatory Disease Clinical Manifestations McCance KL, Huether S. Pathophysiology. 7th ed. N.S.W, Mosby; 2015 Asymptomatic in early stages Increasing transmission to others Ascending infection Inflammatory and immune response intensifies Pelvic and lower abdominal pain Purulent cervical discharge Cervical tenderness Fever Malaise  Pelvic Inflammatory Disease Diagnostic Criteria History Physical examination/laparoscopy Lower abdominal tenderness on palpitation Adnexal (uterus supporting tissues) tendernes s Cervical motion tenderness Presence of discharge Cervicitis Laboratory studies Inflammation: ESR or CRP (erythrocyte sedimentation rate, C-reactive protein) Infection: STD screening, bacterial cultures from genitourinary tract Thibodeau GA, Patton KT. Anatomy and Physiology. 6th ed. Chatswood, Mosby;2007  Pelvic Inflammatory Disease Treatment Goal of treatment: prevent complications Pelvic adhesions, ectopic pregnancy, abscesses, infertility Oral or intravenous antibiotics Hospitalize, if high risk Pregnant Immunodeficient Presenting with severe illness, nausea, vomiting, or a high fever Unable to follow or tolerate the outpatient treatment with oral antibiotics Potentially in need of emergency surgery, such as if appendicitis cannot be excluded Diagnosed with a tubo-ovarian abscess Treat infected patient and partners Behavioral modifications Abstinence during treatment Until partners are treated and cured