Characteristics of pelvic inflammatory disease where no sexually transmitted infection is identified: a cross-sectional analysis of routinely collected sexual health clinic data

Abstract

These findings highlight uncertainties around PID diagnosis and aetiology. Pathogen-negative-PID could represent (i) a false positive diagnosis where the woman does not have a sexually transmitted infection (STI) or PID, (ii) PID of another microbiological aetiology or associated with a past STI or (iii) PID where the cervical infection has cleared. However, until diagnostic biomarkers are available, PID treatment should be based on clinical features and sexual risk.

Factors associated with pelvic inflammatory disease: A case series analysis of family planning clinic data

“…This case series demonstrates that idiopathic PID (55%) continues to represent a large disease burden, which is in line with previously published findings. 2 , 11 This supports the hypothesis that factors other than currently recognized STIs and gynaecological procedures are involved in PID aetiology, including reproductive tract microbiome factors, 12 or that the infection has ascended and therefore pathogens are not isolated on samples from the lower reproductive tract. 13 Our group is working to further evaluate how these host and microbial factors are involved in PID.…”

“…1 In approximately 60% of cases with PID, no causative pathogen is identified. 2 Where a pathogen is identified, the sexually transmitted pathogens Neisseria gonorrhoea (NG), Chlamydia trachomatis (CT), and Mycoplasma genitalium (MG) may be implicated. 3 It may also be associated with gynaecological procedures such as intrauterine device (IUD) insertion and termination of pregnancy, and sexual behaviour risk factors such as recent change in partner, history of multiple sexual partners, and early age of sexual debut.…”

Performance of a rapid molecular test to detect Chlamydia trachomatis and Neisseria gonorrhoeae in women with pelvic inflammatory disease

“…The diagnosis of PID may be challenging because of the lack of definitive diagnostic criteria 7 . Moreover, patients may report a wide range of clinical manifestations, from mild symptoms to very severe disease 1,2,8,9 , which may be confounded with other etiologies, leading to misdiagnosis and treatment delay and short-(tubo-ovarian abscess and pelvic peritonitis) or long-term complications (impaired fertility, ectopic pregnancy and chronic pelvic pain) 1 . Furthermore, PID represents a significant economic burden considering its management and follow-up and possible long-term complications 4,7,[10][11][12][13] .…”

Mycoplasma genitalium prevalence and macrolide resistance‐associated mutations and coinfection with Chlamydia trachomatis in Southern Jutland, Denmark

“…Mycoplasma genitalium is an emerging sexually transmitted infection with symptoms similar to those for C. trachomatis and N. gonorrhoeae [ 3 ]. The consequences of M. genitalium infection are similar to those for chlamydial infection, including non‐gonococcal urethritis in male subjects and associated with urethritis and pelvic inflammatory disease, infertility, endometritis, ectopic pregnancy and preterm birth [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ].…”