Pelvic Inflammatory Disease
Now, I am going to explain what is A complex sexually indeed transmitted infection is pelvic. The inflammatory disease we will explain. Is a sexually transmitted infection that leads to a clinical syndrome of Inflammation from the cervix to the cervix The endometrium includes the fallopian tubes. Tubes and connecting pelvis. Structures This can be quite serious The action and numbers are beautiful.
Pelvic Inflammatory Disease
Serious as well as a million women. The United States presented with each year. Pelvic inflammatory disease is what we call it. PID You can expect this in about 40%. Women who develop endocervicitis and. Do not take any treatment for this reason. Neisseria gonorrhoeae or chlamydia trachomatis.
sexually active woman
No 1: Women who are likely to have PID. Often three times as young. Women aged 25 to 29 who have Someone with more than one sexual partner
No 2: The new sexual partner inside the previous one
No 3: There are also these with a partner.
other associations
Pelvic-risk behaviors Inflammatory diseases are some Other associations some of which we clearly do not understand and one of the. This is bacterial vaginosis in women These processes are more prone to Developing a PID for these reasons Perhaps a slightly more articulate woman
Who has an intrauterine device more?
Potentially trace organisms. Genital tract women who douche a lot. May also be subject to the pelvis
Inflammatory disease and process. This seems to happen during menstruation. Attractive to women who smoke. The incidence of cigarettes increases. I have a pelvic inflammatory disease. Practically all studies have a methodology. Some speculate that it is not very clear. Cigarette smoke causes cilia. The fallopian tubes are probably dysfunctional. Allows organisms to move up. fallopian tubes and there is an Association that is not well defined. With substance abuse and PID
So the causes of pelvic inflammatory disease
Diseases are these notorious pathogens Again Neisseria gonorrhea Chlamydia
trachomatis and a wide variety of others There are also worms and these include anaerobic ones. bacteria and should be identified. That life in humans and on humans Women are essentially anaerobic anaerobes
For example, the number of aerobes is high. The colon is one thousand to one aerobic Gram-negative rods second colony type Organisms streptococcus I and mycoplasma Can be added very frequently when you Have a pelvic infection Inflammatory disease You actually have mixed organisms on one. A little bit about gram stain smear
 |
| causes of pelvic inflammatory disease |
Pathogenesis is direct
The proliferation of organisms from the canaliculi From the endocervix to the endometrial mucosa And up to the fallopian tubes and that's it. It is not proven but it is assumed that Sexually transmitted organisms eg Neisseria gonorrhoeae caused it. Inflammation of tubule mucosa and They help protect other organisms. Moving up the GI tract. Female genital tract But as I mentioned. precise Mechanisms are very bad, Understood But unfortunately pelvic inflammatory disease. The disease comes with some long term. sequelae such as scarring and when Fallopian tubes are scarred things like
Can an ectopic pregnancy develop?
Clinical features of pelvic
By and large, you have an inflammatory disease. Speaking of a clinical diagnosis And we are wrong rather than doctors
How do we make this assessment?
The positive predictive value is between 65 And 90 percent compared to the gold standard for laparoscopy, in addition, Many episodes go undiagnosed because Women have PID but they don't.
Have or have symptoms. But the bottom line is good if it's light. The Doctor must have his own antenna. Because the diagnosis can be many Very subtle and as a result we often
Empirical treatments need to be used.
The classic clinical picture would be a woman with lower right abdominal pain. Quadrant Left lower quadrant or Bilateral lower abdominal pain and all Patients who present as such. There should be an emergency department
pelvic test
broad-spectrum antibiotics On pelvic examination and pelvic exam Would be a classic find. cervical movement with tenderness Minimal cervical movement often Causes excruciating pain in women.
Checking is being done and it will be smart The physician performing the pelvic exam warns the woman that he is approaching her. Or she is going to move the cervix and Women must be mentioned.
It is very painful or not. Another thing you might expect. There are white blood cells in the vagina.
secretion and if the woman is not white. Cells and vaginal secretions no cervical Discharge He probably doesn't have PID. However, bacterial vaginosis is a marker. mew copula cervicitis and definitely a
Test for Neisseria gonorrhoeae
Chlamydia trachomatis is an indication For most empirical treatments Patients have a temperature
Above 38 degree Celsius but few Patients have fevers sub The tests we use most often will be tests. For exaltation with recitation Sedimentation rate or seed rate or c, All of these are reactive proteins. Indications for experimental treatment
laparoscopy
PID when the diagnosis is still pending. Doubt or if our empirical practices Whatever we chose didn't seem to work Then it may be a clue to a. For laparoscopy and in general Experimental therapy or patient failure. Those with a history of PID and negative Tests for gonorrhea or chlamydia Bacterial vaginosis is that which may require laparoscopy. Also, there is laparoscopy. Used to detect Fitzhuve-Curtis syndrome. When he gets perihepatitis.
So how do we treat PID?
NO 1; Fortunately, we have treatments. We will treat most patients as an outpatient
NO 2; For hospitalized patients only
NO 3; Clinically severe illness High fever Nausea Vomiting or incapacitating patients Insist or follow up orally on an outpatient basis. Conduct and includes you know a large minority of people To protect the mother, of course, And the child hospitalized all pregnant women with PID and a major concern
Is there pus that needs to be drained?
treatment of Pelvic Inflammatory Disease
A tube ovarian cyst so they will. Need to enter because antibiotics A large abscess will fail to resolve.
Antibiotics are not well absorbed. An abscess is needed as we say in medicine. Fresh air and sun need drainage. And then sometimes there is acute appendicitis. In the differential diagnosis and when a physician cannot rule out appendicitis Pelvic relaxation is another form of therapy. It is very important to solve it. process and so on in the case of treatment Patients with antibiotics We use a combination of outpatients.
Intramuscular and oral regimens and The classic regimen is ceftriaxone. You remember that this is the cure. Gonorrhea We also add doxycycline twice. A day for 14 days and it will cover. Our chlamydia and mycoplasma organisms If they exist we will add them too.
metronidazole no metronidazole will is an Excellent agent for anaerobic treatment Organisms that may be involved. Infection as I mentioned and also. Treatment of bacterial vaginosis Another mechanism may exist Usually used to be
Cefoxitin plus probenecid To keep cefoxitin levels high Plus doxycycline plus metronidazole now For the inpatients, we are going to use. Basically IV cefoxitin every 12 hours or every 6 hours plus doxycycline every Which will cover aerobics. Gram-negative rods and anaerobes Some alternative parenteral regimens include:
For example, the choice would be ampicillin. So be supported which is beta-lactam. A beta-lactamase inhibitor that covers anaerobes very well and then Doxycycline
follows steps to improve
So we would expect patients to improve.
NO 1; If not, within three days of Improvement after our outpatient Intramuscular or oral therapy we will do
NO 2; Then admitted to the hospital and re-examined us.
NO 3; Antibiotic regimens and considerations.
NO 4; We will also do diagnostic laparoscopy.
NO 5; Repeat tests for Neisseria gonorrhoeae. And Chlamydia trachomatis and then three months after treatment we will retest.
NO 6; Again we would expect clinical.
NO 7; Another improvement in three days
NO 8; The important thing is that we give advice on Patient problems and Complications of pelvic inflammatory disease Illness and we have to be honest.
Management of sex patient
Tell patients that there is an increase. Cases of ectopic pregnancy because of Scarring of fallopian tubes and adhesives produced as part of this process
So in terms of stopping further Episodes of PID, We would suggest that a person who has come before a woman. With PID during 60 days from initiation Symptoms should be checked. Gonorrhea and chlamydia now for women.
Whose last sex was more?
Over 60 days we would recommend that we The most recent sexual partner treatment for Both gonorrhea and chlamydia experimentally We will also recommend abstinence. Sexual intercourse until therapy is complete And the symptoms have resolved Totally a woman and for her partner and that brings us to our End of the pelvic floor discussion Inflammatory disease you
.jpg)
