Pediatric emergency medicine trisk 2135 2135
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TABLE 92.2
DIAGNOSTIC CRITERIA FOR PELVIC INFLAMMATORY DISEASE
Minimum criteria
Additional criteria
Specific criteria
Sexually active patient with pelvic or lower abdominal
pain, no cause other than PID identified, and one of
the following:
Cervical motion tenderness or
Uterine tenderness or
Adnexal tenderness
These findings enhance the specificity of the minimum
criteria and support a diagnosis of PID:
Oral temperature >101°F (>38.3°C)
Abnormal cervical or vaginal mucopurulent discharge
Abundant numbers of white blood cell on saline
microscopy of vaginal secretions
Erythrocyte sedimentation rate >15 mm/hr
Elevated C-reactive protein
Documented gonococcal or chlamydial cervical
infection
These findings offer a definitive diagnosis of PID:
Endometrial biopsy with histopathologic evidence of
endometritis
Laparoscopic abnormalities consistent with PID
Transvaginal sonography or magnetic resonance
imaging techniques showing thickened, fluid-filled
tubes or tuboovarian complex, or Doppler studies
showing tubal hyperemia
PID, pelvic inflammatory disease.
Adapted from Workowski KA, Berman S; Centers for Disease Control and Prevention. Sexually transmitted
diseases treatment guidelines, 2010. MMWR Recomm Rep 2010;59(RR-12):1–110.
Triage Considerations
The majority of patients with PID will be stable. However, patients presenting
with an ill appearance or peritonitis require prompt treatment and surgical
consultation. These findings may suggest a complication such as a perforated
tuboovarian abscess.
