Pelvic Inflammatory Disease (Deep Dive R27)
EM Clerkship
Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD
4.9 • 816 Ratings
🗓️ 15 November 2021
⏱️ 15 minutes
🧾️ Download transcript
Summary
* 50% of cases of Pelvic Inflammatory Disease (PID) is caused by common STIs (Gonorrhea, Chlamydia ) but up to 50% is caused by native vaginal flora/other organisms* No SINGLE historic, physical, or laboratory finding is both sensitive and specific for the diagnosis of acute PID* Women with PID may be asymptomatic!!* Presumptive treatment of PID should be initiated for sexually active women if they are experiencing pelvic/lower abdominal pain and if…* No alternative explanation can be found to explain patient’s pain, OR* ANY one of the three following findings are discovered on pelvic examination: cervical motion tenderness, adnexal tenderness, uterine tenderness* All antibiotics used to treat PID should also be effective against Gonorrhea and Chlamydia because negative endocervical screening for these organisms do not rule out upper genital tract infection* Many antibiotic treatment combinations exist: Ceftriaxone, Doxycycline, and Metronidazole is a common regimen
Further Reading: CDC STI Treatment Guidelines
Transcript
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| 0:00.0 | Hello, residents. My name is Zach Olson and thank you for downloading this month's deep dive. |
| 0:07.9 | In the last case, Mike actually had two patients with sexually transmitted infection, one of which had pelvic inflammatory disease, PID, and that's what I wanted to dive into a bit during this episode. |
| 0:20.2 | But before we do, this episode was |
| 0:22.3 | sponsored by Pearson Rabbit's Insurance. As you know at this point, Stephanie Pearson at Pearson |
| 0:27.2 | Ravits is my personal disability and life insurance agent. And the reason I like her so much is |
| 0:33.0 | because she is an educator at heart. She won't just sell you a policy. Being a disabled physician |
| 0:40.0 | herself, she is there to answer your questions. She's there to help you compare policies |
| 0:44.5 | between different companies and help you make the best choice for your specific situation. |
| 0:50.3 | She's an independent agent, which means she is not forced to sell you a policy from any one particular company. |
| 0:56.2 | She is there to help you pick your best policy for your situation and good own occupation policy, |
| 1:03.2 | help you purchase it at the right time, and make the whole process as painless as possible. |
| 1:08.0 | I couldn't recommend her more highly. |
| 1:10.3 | Go to www. Pearsonravats.com and set up your appointments so you can educate and protect |
| 1:15.9 | yourself. |
| 1:16.8 | Now, back to our episode. |
| 1:19.0 | Okay. |
| 1:20.0 | Pelvic inflammatory disease. |
| 1:21.8 | You might not know this, but this is a very pertinent topic right now because in 2021, this |
| 1:27.1 | year, the CDC just released a new set of |
| 1:30.7 | guidelines on pelvic inflammatory disease and you will find that many attendings are not even |
| 1:36.3 | aware of these guidelines yet so this is an opportunity where you can really make yourself be up to |
| 1:41.1 | date and you can really shine i want to be honest with you too. I learned |
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