A patient that is 32 yo and has been married to her husband for 10 years, come in complaining of pelvic pain that is new, constant and worsening for about 3 weeks. She states she did not come in sooner because her husband works out of town for long periods and she did not have anyone to take care of their 3 children while she comes in to see you. He is home now and they tried having sex last night but she stated it was too painful and they had to stop. She reports a small amount of post-coital bleeding after their attempt. She states she has not had this kind of pain before but denies any dysuria or problems with defecation with this pain. She also denies any GI symptoms at this time. Her Temp is 100.3 today, P 82, BP 102/74, O2 SAT100%. Abdominal exam negative for HSM or any mass, but mild LQT noted without guarding. Pelvic exam reveals normal external genitalia, vaginal walls pink and a moderate amount of thin gray vaginal discharge is noted in the posterior fornix, but otherwise normal. Bimanual exam is significant for positive CMT and left adnexal pain.
CC: “I have pain in my pelvis”.
1. What is the differential diagnosis for this scenario?
2. What are the most common organisms that can cause PID?
3. What are the presenting symptoms of PID?
4. What test need to be performed to get a definitive diagnosis of PID?
5. How do you manage PID?
6. What teaching and follow-up is needed in PID?