Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- 58 Urethritis and Dysuria
- 59 Vaginitis and Cervicitis
- 60 Epididymo-Orchitis
- 61 Genital Ulcer Adenopathy Syndrome
- 62 Prostatitis
- 63 Pelvic Inflammatory Disease
- 64 Urinary Tract Infection
- 65 Candiduria
- 66 Focal Renal Infections and Papillary Necrosis
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
63 - Pelvic Inflammatory Disease
from Part VIII - Clinical Syndromes – Genitourinary Tract
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- 58 Urethritis and Dysuria
- 59 Vaginitis and Cervicitis
- 60 Epididymo-Orchitis
- 61 Genital Ulcer Adenopathy Syndrome
- 62 Prostatitis
- 63 Pelvic Inflammatory Disease
- 64 Urinary Tract Infection
- 65 Candiduria
- 66 Focal Renal Infections and Papillary Necrosis
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
INTRODUCTION
The current emphasis on evidence-based medicine has poorly served our approach to pelvic inflammatory disease. On paper, the goal of determining the best therapeutic strategy by prospective randomized double-blind studies is laudable, but it makes the assumption that patients with similar risk factors can be grouped into large study groups for such endeavors. It is increasingly apparent that this has not been the case.
Pelvic inflammatory disease (PID) is a classification that attempts to encompass too-wide a range of clinical syndromes. It includes seriously ill women with a tubo-ovarian abscess, who require hospitalization, intravenous antibiotics, and sometimes operative intervention for a cure. In contrast, most women with PID either are asymptomatic or have such mild symptoms that they do not seek medical care. To address these concerns, the International Infectious Disease Society for Obstetrics-Gynecology (I-IDSOG-USA) suggested the term upper genital tract infection (UGTI) be used with the designation of the etiologic agent. In addition, the UGTI can be placed in stages, depending on the clinical severity of the infection.
Epidemiologic studies have added to the confusion about risk factors for PID. Since the early 1980s, study after study has shown bacterial vaginosis (BV) and douching as risk factors for the development of PID, but in separate prospective studies on BV and douching, no increased risk was seen.
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- Chapter
- Information
- Clinical Infectious Disease , pp. 445 - 448Publisher: Cambridge University PressPrint publication year: 2008