Pelvic inflammatory disease

Prognosis for complete recovery is good in patients treated within 3 days of symptom onset and who are able to complete the full course of therapy. Clinical and microbiological cure rates of 88% to 100% have been reported after oral antibiotic treatment.[9]Scholes D, Stergachis A, Heidrich FE, et al. Prevention of pelvic inflammatory disease by screening for cervical chlamydial infection. N Engl J Med. 1996 May 23;334(21):1362-6. https://www.nejm.org/doi/full/10.1056/NEJM199605233342103 http://www.ncbi.nlm.nih.gov/pubmed/8614421?tool=bestpractice.com The risks of tubal occlusion and infertility depend on severity of infection before treatment. Clinical improvement may not translate into improved fertility.[45]Ross J. Pelvic inflammatory disease. Clin Evid. 2006 Jun;(15):2176-82. http://www.ncbi.nlm.nih.gov/pubmed/16973083?tool=bestpractice.com Patients who have co-existent conditions (HIV infection, pregnancy, prior PID or tubo-ovarian abscess), or who have an IUD, require close observation and may require hospitalisation.

Factors that predict poor clinical course ( i.e., hospitalisation >7 days and/or a requirement for surgery) among patients hospitalised with PID have been identified. They are: advanced age, history of previous open gynaecological surgery, any cystic lesion identified by ultrasonography, and high C-reactive protein levels.[46]Terao M, Koga K, Fujimoto A, et al. Factors that predict poor clinical course among patients hospitalized with pelvic inflammatory disease. J Obstet Gynaecol Res. 2014 Feb;40(2):495-500. http://www.ncbi.nlm.nih.gov/pubmed/24118399?tool=bestpractice.com