Pelvic Inflammatory Disease: Pathophysiology and Medical Management

In: Clinical Perspectives in Obstetrics and Gynecology · 1989 · pp. 107–117 · doi:10.1007/978-1-4684-0330-5_7 · W7811082
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Pelvic inflammatory disease is an ascending genital tract infection causing abdominal pain, where clinicians aim to prevent chronic or surgical complications through appropriate therapy.

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This chapter reviews acute pelvic inflammatory disease (PID) as an infectious process that ascends from the lower genital tract to the upper tract, discussing how clinicians evaluate and manage a condition whose infected structures cannot be directly visualized or precisely sampled and cultured. It summarizes evidence about microbiology and pathogenesis, including polymicrobial etiology and roles of pathogens such as Neisseria gonorrhoeae and Chlamydia trachomatis, and describes limitations of antibiotic regimens (for example, failure of beta-lactams to eradicate chlamydial infection in the endometrium despite clinical cure). A key caveat emphasized throughout is the diagnostic challenge posed by the inability to localize infection precisely, which affects treatment decisions aimed at preventing chronic or surgical complications. Relevance to endometriosis: the chapter does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

The problems presented by acute pelvic inflammatory disease (PID) are well known to physicians, who usually see the disease from one of two vantage points. PID may first be seen as a medical problem, as it is an infectious process originating in the lower genital tract that subsequently ascends to the upper tract and causes symptoms of abdominal pain. The structures involved cannot be visualized, only palpated, and the precise site of infection cannot be cultured. The goal of the clinician becomes one of selecting an appropriate course of therapy to prevent the disease from becoming a chronic or surgical problem. Preview Unable to display preview. Download preview PDF. Similar content being viewed by others

References

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