Overview
What PID Means Clinically
Pelvic inflammatory disease (PID) is an infection of the upper female genital tract: the endometrium, fallopian tubes, pelvic peritoneum, and sometimes contiguous pelvic structu...
Pelvic inflammatory disease (PID) is an infection of the upper female genital tract: the endometrium, fallopian tubes, pelvic peritoneum, and sometimes contiguous pelvic structures. Organisms usually ascend from the vagina and cervix. The infection is commonly polymicrobial, involving *Neisseria gonorrhoeae*, *Chlamydia trachomatis*, anaerobic and other vaginal flora, and occasionally *Mycoplasma genitalium*. The clinical damage comes from inflammation as much as from the organisms themselves. Tubal inflammation can heal with scarring, narrowing or adhesions, which explains the later risks of tubal-factor infertility, ectopic pregnancy, chronic pelvic pain and recurrent PID. Repeated episodes and delayed treatment increase those risks. That is why treatment is deliberately empiric at a low threshold: waiting for a positive swab or definitive imaging can allow preventable tubal injury. PID may be mild. The patient does not need to have a high fever, dramatic discharge or an abnormal ultrasound before treatment is considered.