Criteria

Centers for Disease Control and Prevention (CDC) criteria[1]

Young, sexually active women and other women at risk for STIs are presumed to have PID if they have pelvic or lower abdomen pain, no other cause for illness, and one or more of the following minimum criteria on pelvic examination:

  • Adnexal tenderness

  • Uterine tenderness

  • Cervical motion tenderness.

Additional criteria to enhance specificity include:

  • Oral temperature over 101°F (>38.3°C)

  • Abnormal cervical or vaginal mucopurulent discharge

  • Presence of white blood cells on saline microscopy of vaginal secretions

  • Elevated erythrocyte sedimentation rate

  • Elevated C-reactive protein

  • Laboratory documentation of cervical infection with Neisseria gonorrhoeae or Chlamydia trachomatis.

Definitive criteria include:

  • Endometrial biopsy with histopathologic evidence of endometritis

  • Laparoscopic findings consistent with PID

  • Transvaginal sonography or MRI showing thickened, fluid-filled tubes with or without free pelvic fluid or tubo-ovarian complex

  • Doppler studies suggesting pelvic infection (e.g., tubal hyperemia).

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