AssessmentsPelvic inflammatory disease
Pelvic inflammatory disease
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 22-year-old woman comes to the emergency room with a fever, chills, and abdominal pain that began this morning. Two months ago, she was diagnosed with a herpes simplex genital infection and treated with valacyclovir. She is sexually active and has multiple sexual partners. She uses condoms inconsistently. Her last menstrual period was four weeks ago. She has not received the human papillomavirus vaccination series. Family history is noncontributory. Temperature is 38.3°C (100.9°F), pulse is 100/min, respirations are 20/min, and blood pressure is 120/75 mmHg. BMI is 32 kg/m2. Speculum examination reveals mucopurulent discharge with a friable, erythematous cervix. Cervical motion tenderness and right adnexal tenderness are present on bimanual examination. An external genital examination is non-contributory. Which of the following clinical sequelae is likely if this patient does not receive appropriate treatment?
Content Reviewers:Viviana Popa
It can cause a number of serious complications, including infertility.
The female reproductive system includes all of internal and external organs that help with reproduction.
The internal sex organs are the ovaries, which are the female gonads, the fallopian tubes, two muscular tubes that connect the ovaries to the uterus, and the uterus, which is the strong muscular sack that a fetus can develop in.
Some mechanisms can make it even easier! For example, the cervical mucus, which normally acts as a barrier preventing bacteria from entering the uterus, may become less effective.
The mucus can become thinner as a result of normal variations throughout the menstrual cycle, or alternatively, it can become less effective in the context of bacterial vaginosis, which is when the normal balance of the vaginal flora is altered, and anaerobic bacteria proliferate and degrade the cervical mucus.
Other factors contributing to an infection may be retrograde menstruation, which is when menstrual blood flows back through the fallopian tubes and into the pelvic cavity instead of out of the body, and also sexual intercourse.
If it also affects the ovaries, it’s called salpingo-oophoritis.
But this actually damages the tubal epithelium and the tubes become filled with pus.
When scar tissue forms to repair the damage, areas with damaged epithelium tend to stick to one another, creating closed-off pockets and little dead-end pouches in the fallopian tubes.
This scarring in the fallopian tubes can lead to a number of complications related to PID.
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