Pelvic inflammatory disease (PID) is a clinical syndrome caused by the ascending spread of micro-organisms from the vagina and endocervix to the endometrium, fallopian tubes and/or contiguous structures.


Classic signs for pelvic inflammatory disease: all of the following:

(1) lower abdominal pain and/or adnexal tenderness

(2) signs of lower genital tract infection

(3) cervical motion tenderness


At least one or more of the following should be present:

(1) erythrocyte sedimentation rate > 15 mm/hr

(2) temperature > 38°C (100.4°F)

(3) palpable adnexal mass

(4) leukocytosis > 10,000 per µL

(5) purulent material in the peritoneal cavity obtained by culdocentesis or laparoscopy

(6) pelvic abscess or inflammatory complex detected by bimanual examination or by sonography

(7) patient is a sexual contact of a person known to have gonorrhea, chlamydia or nongonococcal urethritis

(8) patient meets the surveillance case definition of C. trachomatis infection or gonorrhea


Other causes of lower abdominal pain such as ectopic pregnancy or acute appendicitis should be excluded.


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