ABSTRACT
This chapter presents a case study of a 45-year-old woman who attends the Emergency Department feeling feverish, nauseous and generally unwell. The most likely diagnosis in this patient is pelvic inflammatory disease (PID). PID is the clinical syndrome associated with an upper genital tract resulting from ascending infection from the endocervix. Typical features that may be elicited from the history that are suggestive of PID include bilateral lower abdominal pain, deep dyspareunia, abnormal vaginal discharge and fever. Differential diagnosis of lower abdominal pain in young women includes ectopic pregnancy, endometriosis, appendicitis, ovarian cyst torsion or rupture and urinary tract infection. Women with mild or moderate PID can be managed in the community with oral antibiotics. Delaying treatment of PID increases the risk of long-term complications and therefore a low threshold for empirical treatment of PID is recommended. The need for contact tracing, screening and treatment should be discussed to prevent reinfection.
