Pelvic inflammatory disease

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Pelvic inflammatory disease (or disorder) (PID) is a generic term for inflammation of the uterus, fallopian tubes, and/or ovaries as it progresses to scar formation with adhesions to nearby tissues and organs. This may lead to infections. PID is a vague term and can refer to viral, fungal, parasitic, though most often bacterial infections. PID should be classified by affected organs, the stage of the infection, and the organism(s) causing it. Although an STI is often the cause, many other routes are possible, including lymphatic, postpartum, postabortal (either miscarriage or abortion) or intrauterine device (IUD) related, and hematogenous spread. Two thirds of patients with laparoscopic evidence of previous PID were not aware they had PID.[1]

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Epidemiology

In the United States, more than a million women are affected by PID each month, and the rate is highest with teenagers and first time mothers. PID causes over 100,000 women to become infertile in the US each year.[2] N. gonorrhoea is isolated in 40-60% of women with acute salpingitis.[3] C. trachomatis is estimated to be the cause in about 60% of cases of salpingitis, which may lead to PID. However, not all PID is caused solely by STIs; organisms that are considered normal vaginal flora can be involved, and individual cases of PID can be due to either a single organism or a co-infection of many different species. 10% of women in one study had asymptomatic Chlamydia trachomatis infection and 65% had asymptomatic infection with Neisseria gonorrhoeae.[3] It was noted in one study that 10-40% of untreated women with N. gonorrhoea develop PID and 20-40% of women infected with C. trachomitis developed PID.[1] PID is the leading cause of infertility. "A single episode of PID results in infertility in 13% of women."[1] This rate of infertility increases with each infection.

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