My Clinical Notes

• Characterised by;
  • Pelvic pain
  • Adnexal tenderness
  • Fever
  • Vaginal discharge

 

• Results from infection by either;
  • Gonococcus
  • Chlamydiae
  • Enteric bacteria
• In the case if spontaneous/induced abortions and delivery can also be caused by;
  • Staphylococci
  • Streptococci
  • Coliform bacteria
  • Clostridium perfrigens
  • These tend to spread up the genital tract by the vasculature rather than the mucosa

 

• Once gonococcus is with the fallopian tubes acute suppurative salpingitis develops
• The tubal serosa becomes hyperaemic and layered with fibrin
• The lumen fills with purulent exudates that may leak out via the fimbrial end
• In days or weeks the fimbria may seal against the ovary to create salpingo-oophoritis
• Collections of pus within the ovary and tube (tubo-ovarian abscess) or tubal lumen (pyoslapinx) may occur
• Adhesions of the tubal plica ,may produce glandlike structures (follicular salpingitis)
• In the course of time, the pus may breakdown to a thin serous fluid to form a hydrosalpinx
• PID caused by strep, straph and the other puerperal organisms produce less exudation within the tube lumen with less involvement of the mucosa and more inflammation in the deep layers
• The infection tends to spread throughout the wall to involve the serosa, broad ligament, pelvic structures and peritoneum
• Staph and strep infections are more likely to cause a bacteraemia

 

• Complications of PID
  • Peritonitis
  • Intestinal obstruction due to adhesions
  • Bacteraemia (may produce endocarditis, meningitis, suppurative arthritis)
  • Infertility

This entry was posted on Wednesday, October 3rd, 2007 at 4:25 pm and is filed under Gynaecology/Obstetrics. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.