Pelvic inflammatory disease: Difference between revisions

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** [[Is treated by::Ofloxacin]] 400 mg PO bid for 14 days, ± [[Is treated by::metronidazole]] 500 mg IV q8h
** [[Is treated by::Ofloxacin]] 400 mg PO bid for 14 days, ± [[Is treated by::metronidazole]] 500 mg IV q8h
** [[Is treated by::Levofloxacin]] 500 mg PO daily, ± [[Is treated by::metronidazole]] 500 mg IV q8h
** [[Is treated by::Levofloxacin]] 500 mg PO daily, ± [[Is treated by::metronidazole]] 500 mg IV q8h
* Often recommended to add [[Is treated by::metronidazole]] to any of the above regimens that do not have
* Often recommended to add [[Is treated by::metronidazole]] to any of the above regimens that do not have adequate anaerobic coverage, though it is unclear whether this makes any difference
* Only consider fluoroquinolones if there is susceptibility testing done or a test of cure is possible
* Only consider fluoroquinolones if there is susceptibility testing done or a test of cure is possible
* If an intrauterine device is in situ, remove it only after at least 2 doses of antibiotics have been given
* If an intrauterine device is in situ, remove it only after at least 2 doses of antibiotics have been given

Revision as of 00:58, 11 November 2019

  • Upper genital tract infection in women that involves a combination of endometrium, fallopian tubes, and peritoneum

Background

Microbiology

Epidemiology

  • About 10-15% of women have at least one episode

Clinical Presentation

  • Pelvic or abdominal pain is the main complaint
  • May be febrile and have adnexal, uterine, or cervical motion tenderness
  • Must rule out an ectopic pregnany
  • May present with tuboovarian abscess

Investigations

  • β-hCG to rule out ectopic pregnancy
  • Endocarvical swabs for gonorrhea and chlamydia, and possibly HSV
  • Vaginal swabs for culture, pH, whiff testing, wet preps, and Gram stain
  • Ultrasound can be helpful, especially for tuboovarian abscess

Management

Further Reading