Originally Answered: Anybody have any info on a Pelvic Inflammatory Disease?
This is the common problem in women.The causative organisms include vast majority including M. tuberculosis,N. gonorrhoeae,C. trachomitis etc.It can be a case of acute Pelvic Inflammatory Disease (PID) or a chronic PID.
Modes of aquisition:
1.Most commonly the organism ascend through vagina and reach upto the overis through cervix,uterus,fallopian tubes.It's usually aquired after sexual intercourse with an infected person or may occur spontaneously.
2.Also from adjacent organs like appendix,intestines while they are infected.
3.Very rarely blood borne infection may occur as in tuberculosis
depending upon the site infected it can be salpingitis (fallopian tubes) or Endometritis (uterus).
Salpingitis is most important as it causes inflammation,edema,loss of cilia and cause adhesions into the leumen of tubes as well as around the tubes and lead to infertility.
Ovaries are invariably involves forming tubo-ovarian mass.The infection can spread to other pelvic organs by outpouring the pus that is formed in F. tubes through the fimbrial end.
In acute case the woman has complains of acute inflammation such as pain in the lower abdomen,fever,foul smelling discharge through vagina etc.
On per speculum examination,the vagina,cervix are inflammed,lots of foul smelling discharge is present.
Abdominal examination may show tenderness,muscels are contracted (guarding and rigidity).
In chronic inflammation the woman usually doesn't have any complain other that chronic,vague pain in lower abdomen or backache.She may also come directly with the complain of infertility only to reveal chronic PID after investigations.
Haemoglobin,total leucocyte count as a routine.Diabetes has to be ruled out.High vaginal swabs are taken for culture and sensitivity.Also blood sample may be used for culture and sensitivity in case of blood born infection.Abdominal ultrasonography has to be done.Laproscopy helps to identify the extent of spread of the disease in ajscent organs,adhesions of fallopian tubes to adjacent organs,involvement of ovary etc.
Also thorough search for the source of infection has to be made and it has to be treated too or relapse may occur.
Acute PID had to be treated on with antibiotics,maintenance of hydration,rest.Drainage of the abscess if it has formed is important
Chronic PID usually has bad prognosis as the disease has already progressed to such as extent from where recovery is impossible.The woman has to resort other way for pregnancy if she wants.