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Feature Article

A GP's guide to pelvic inflammatory disease

Ian Jones

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Abstract

Pelvic inflammatory disease (PID) is a serious infection in women that has important consequences for both the short and long term. Caring for patients and their contacts requires a sensitive and thorough approach.

Key Points

  • Most cases of PID are caused by an ascending infection, with sexually acquired Chlamydia trachomatis and Neisseria gonorrhoeae being the most common pathogens. However, other organisms may be involved when the normal barriers to infection are breeched – for example, during childbirth.
  • A high index of suspicion is required to diagnose PID and STIs. Presentations vary according to the cause and severity of the disease, and all features may be absent or mild in the early stages.
  • Patient education and reassurance about the security of information, and requirements for disease notification and contact tracing are important aspects of management.
  • If a woman is treated for PID and her symptoms and signs do not resolve then the diagnosis should be reconsidered.
  • There are serious long term consequences of PID. These include chronic pelvic pain and infection, and tubal occlusion with infertility. In addition, the rates of ectopic pregnancy are increased several fold.

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