Sexually transmitted diseases are the commonest causes of PID or pelvic inflammatory disease. This is by no means the only cause of PID.
Almost any infection can cause PID. These infections could be blood borne, or as a result of direct contact from devices like intrauterine contraceptive device, or even through our lymphatic channels.We shall discuss these causes of PID below.
Syphilis is no longer very common, but remains a cause of pelvic inflammatory disease.
It may be surprising to know that despite PID being caused by sexually transmitted disease, test for these infections may be negative in up to 30 percent of patients with PID (CEG, 2005).
Specialised test like the use of Nucleic Acid Amplification Test (NAAT) or Polymerase Chain Reaction (PCR) where available and affordable may improve yield and organism identification.
This could be the case in women who clean themselves from behind towards the front, transferring bowel organism from the anus into the vagina, where they find a save passage upwards.
Direct infection can also follow insertion of Intra Uterine Contraceptive Devices – coils or IUCD, as well as following the use of improperly sterilized instruments in a woman’s vagina or womb, say during termination of pregnancy, delivery, or other procedures. Actimomycetes infection is commonly found in PID associated with IUCDs.
Causes of PID through direct infection from hospital procedure is also common where improperply sterilized instruments are used.
So, Apart from these conditions being a potential cause of PID, they also cause abdominal pain that mimics PID.
Apart from knowing the above causes of PID, it is vital to recognise risk factors for PID which includes:
1. CEG (2005) National guideline on the management of pelvic inflammatory disease. Clinical Effectiveness Group (Association for Genitourinary Medicine and the Medical Society for the Study of Venereal Diseases). www.bashh.org [Accessed: 31/10/2005]
2. Barrett, S. and Taylor, C. (2005) A review on pelvic inflammatory disease. International Journal of STD & AIDS 16(11), 715-720
3. Undergraduate Obtretricks and Gynaecology by M G R Hull, D N Joyce and Gillian Turner
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