General approach to Pelvic Inflammatory Disease (PID): a narrative review

Abstract

Objective: Clarify information and contribute to the medical literature on the subject of Pelvic Inflammatory Disease (PID). Bibliographic review: PID is a polymicrobial infection of the female upper genital tract whose main etiologic agents are Chlamydia trachomatis and Neisseria gonorrhoeae. Its main risk factors are young women on low economic status who practices unprotected sexual activity, especially those who suffers from Sexually Transmitted Infections (STI’s). Manifestations can be asymptomatic or oligosymptomatic, with the main symptom being pain in the lower abdomen, bilateral and acute, during or after menstruation. Complications can range from chronic pelvic pain to pelvic abscess and infertility. The diagnosis of PID is confirmed with three majors and one minor criteria, or only one elaborated criterion. Treatment starts immediately, and tests for STI’s should also be performed. The therapeutic approach is related to the severity of the condition, and the patient can be treated on an outpatient or inpatient basis. With regard to medications, ceftriaxone, doxycycline and metronidazole are generally used. Final considerations: PID remains difficult to diagnose and tends to be lately identified by the health system, especially because it contains a diverse range of clinical manifestations, which, when mapped and classified, must be promptly treated.