A 23-year-old female presents to the emergency room with fever, pelvic pain, vomiting, and dysuria. She reports having had an abortion yesterday in an urban birth control clinic

Question

On physical examination, there is a bloody vaginal discharge, tenderness of the left lower quadrant of the abdomen, and cervical tenderness on pelvic examination. The following is a likely diagnosis:
A. Neisseria gonorrhea infection
B. Chlamydia trachomatis infection
C. Staphylococcal endometritis
D. Fulminant candidiasis

Answer 1

ANS: C
PID is defined as an infection of the uterus, fallopian tubes, and adjacent pelvic structures. It is often secondary to an STD or other infection of the lower reproductive tract that migrates upward into the uterus and tubes. N. gonorrhea and C. trachomatis are two of the commonly offending organisms. Pelvic infections can also occur postsurgery, postpartum, or postabortion but are generally caused from other organisms, such as staphylococcus or streptococcus. Abdominal pain, mucopurulent cervical discharge, and often fever are the more common presenting symptoms. Rebound tenderness indicates peritoneal irritation. Dysuria, nausea, and vomiting may also be present. The abdominal pain is midline and often accompanied by right and left lower quadrant pain, particularly when accompanied by salpingitis. During the pelvic examination, there is pain with cervical motion and with palpation of the uterus and ovaries.