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Family and Community Medicine

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Abstract

Background: Pelvic inflammatory disease (PID) refers to acute and subclinical infection of the upper genital tract in females encompassing uterus, fallopian tubes, and ovaries. The involvement of the neighboring pelvic organs often accompanies this disease, resulting in endometritis, salpingitis, oophoritis, peritonitis, perihepatitis, and tubo-ovarian abscess. Most PID cases, 85% are caused by sexually transmitted or bacterial vaginosis-associated pathogens. The remaining 15% are associated with enteric or respiratory pathogens that have colonized the lower genital tract. The etiologic differences among these processes have significant implications for treatment and prevention.

Case presentation: A 21-year-old female G6-P5-A1 presented to the ED with lower abdominal and genital area pain for four days before admission. The patient has a history of chlamydia infection five years ago and recently has a new sexual partner.

She was treated with oral antibiotics as an outpatient. However, the pain did not subside and was associated with pain in the back and both inguinal areas.

She had fever, chill, night sweats, dysuria, frequency urgency, and hematuria. but denies nausea and vomiting.

Vital signs at the ED were temp. 38°C, heart rate 116/min, and blood pressure 110/70 mmHg.

The pelvic exam was painful and showed purulent discharge, as well as multiple blisters at the perineal area with a white discharge.

Lab results showed positive HSV1, negative other STDs, and a negative pregnancy test. US of the abdomen and pelvis was unremarkable. CT of the abdomen and pelvis showed mild bilateral iliac and bilateral inguinal lymphadenopathy. The largest lymph node in the left inguinal region measured 14 mm on the short axis. No acute abnormality is detected otherwise. The patient was admitted with sepsis and PID. She was treated with IV antibiotics as well as antiviral medications. Three days later, she recovered and was discharged on oral medication.

Conclusion: PID represents a spectrum of infections, which remains common in the community and hospital settings. No single diagnostic gold standard tool exists, and clinical diagnosis remains the most practical approach. Early diagnosis and treatment are critical to prevent the risk of long-term sequelae and fertility preservation.

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Pelvic Inflammatory Disease Associated with Genital Herpes Simplex Virus Type-1 Infection - A Case Report

Background: Pelvic inflammatory disease (PID) refers to acute and subclinical infection of the upper genital tract in females encompassing uterus, fallopian tubes, and ovaries. The involvement of the neighboring pelvic organs often accompanies this disease, resulting in endometritis, salpingitis, oophoritis, peritonitis, perihepatitis, and tubo-ovarian abscess. Most PID cases, 85% are caused by sexually transmitted or bacterial vaginosis-associated pathogens. The remaining 15% are associated with enteric or respiratory pathogens that have colonized the lower genital tract. The etiologic differences among these processes have significant implications for treatment and prevention.

Case presentation: A 21-year-old female G6-P5-A1 presented to the ED with lower abdominal and genital area pain for four days before admission. The patient has a history of chlamydia infection five years ago and recently has a new sexual partner.

She was treated with oral antibiotics as an outpatient. However, the pain did not subside and was associated with pain in the back and both inguinal areas.

She had fever, chill, night sweats, dysuria, frequency urgency, and hematuria. but denies nausea and vomiting.

Vital signs at the ED were temp. 38°C, heart rate 116/min, and blood pressure 110/70 mmHg.

The pelvic exam was painful and showed purulent discharge, as well as multiple blisters at the perineal area with a white discharge.

Lab results showed positive HSV1, negative other STDs, and a negative pregnancy test. US of the abdomen and pelvis was unremarkable. CT of the abdomen and pelvis showed mild bilateral iliac and bilateral inguinal lymphadenopathy. The largest lymph node in the left inguinal region measured 14 mm on the short axis. No acute abnormality is detected otherwise. The patient was admitted with sepsis and PID. She was treated with IV antibiotics as well as antiviral medications. Three days later, she recovered and was discharged on oral medication.

Conclusion: PID represents a spectrum of infections, which remains common in the community and hospital settings. No single diagnostic gold standard tool exists, and clinical diagnosis remains the most practical approach. Early diagnosis and treatment are critical to prevent the risk of long-term sequelae and fertility preservation.

 

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