Clinical features: Pelvic inflammatory disease (PID) occurs when there is infection in the female reproductive organs. The infection can happen as an ascending infection from the vagina, after delivery (puerperal sepsis), after an abortion (septic abortion) postmenstrual or after Dilatation and Curettage (D&C) operation. The common causative organisms are, Neisseria gonorrhea, Chlamydia trachomatis and Mycoplasma hominis. Endogenous bacteria e.g. gram-negative aerobes and anaerobes like bacteroides, streptococcus, anaerobic streptococcus and E. coli may also cause PID. The condition can either be acute, sub-acute, chronic or acute. The main clinical features are lower abdominal pain, backache, vomiting, vaginal discharge, menstrual disturbance, dyspareunia, fever, infertility and tender pelvic masses. PID predisposes to ectopic pregnancy.

Treatment guidelines

In acute PID give Intravenous Dextrose 5%

Co-trimoxazole (O) 10 tablets of 480 mg stat followed by

Tetracycline (O) 500 mg every 6 hours for 14 days

and

Metronidazole (O) 400-500 mg every 8 hours for 10 days

Acetylsalicylic acid (O) 600 mg every 8 hours preferably after food.

In chronic PID

give an appropriate analgesic aspirin or paracetamol depending on the severity of the pain.