Zdjelična upalna bolest

Pelvic Inflammatory Disease (PID) is an infection of the female upper genital tract that includes one or more anatomical structures including the endometrium, fallopian tubes, ovaries, myometrium, uterine serosa and the pelvic peritoneum. It is most often the result of ascending mucosal spread of the pathogen from the lower part of the reproductive system. PID is commonly caused by sexually transmitted microorganisms, N. gonorrhoeae and C. trachomatis, as well as microorganisms comprising the endogenous vaginal and cervical flora. Untreated infection can lead to persistent infection with ascension of the microorganism in the upper genital tract which can cause severe acute morbidity with number of serious complications most commonly tubal infertility, ectopic pregnancy and chronic pelvic pain. Since there are no pathognomonic clinical signs or symptoms of PID, diagnosis requires high expertise of a physician. Also, no diagnostic test is sensitive enough or specific enough, so the diagnosis is made primarily based on clinical assessment. Modern principles of treatment regimens should provide broad spectrum coverage that is effective against most common microorganisms. Oral therapy for acute PID is currently the most commonly used approach. Hospitalization is necessary for patients with tuboovarian abscess and for those who are pregnant, severely ill and unable to follow or tolerate an outpatient oral regimen or if no clinical improvement occurs after three days. Male partners of women diagnosed with acute PID should also be examined and treated.