Data gathering

  • Red flags – IMB, PCB, LMP
  • Others – abdo pain, dyspareunia, fever, PV discharge, dysuria, sexual history
  • Examine – abdominal exam, vaginal exam, speculum


Clinical management

  • Investigations
    • Endocervical swabs – gonorrhoea, chlamydia
    • Vaginal swab – candida, BV
    • Bloods – FBC, CRP
    • Pregnancy test
    • Pelvic USS
  • Explanation
    • PID usually caused by infection spreading from the vagina to the womb or ovaries. Usually causes abdominal pain. Antibiotics to treat infection. Important to treat early as it can affect fertility if going for a long time and increase risk ectopic.
  • Treatment
    • Mild/moderate – ofloxacin 400mg BD + metronidazole 400mg BD – 14d
    • Severe – IV antibiotics and consideration of salpingectomy
    • Refer if – PID in pregnancy, tubo-ovarian abscess, poor response to oral antibiotics
    • Contact tracing
  • Follow-up / Safety net – see again in 3d