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• W2039291136 abstract "Nongonococcal PID remains a major concern in gynecology and an important public health problem. Although debate continues as to the etiologic role of nongonococcal organisms in acute PID, anaerobic and aerobic bacteria, C. trachomatis, and mycoplasmas have all been implicated. Actinomycotic PID is uniquely related to IUD use. The optimal treatment for nongonococcal PID is unknown, but tetracycline and its derivatives are effective against a broad spectrum of nongonococcal organisms. Abscesses and infertility, in particular, are serious complications of nongonococcal PID. While evolving knowledge about the polymicrobial etiology of acute PID has challenged traditional concepts, continued research should clarify the epidemiology, treatment, and prevention of this important disease.Several obstacles to the investigation of nongonococcal pelvic inflammatory disease (PID) are described. The incidence and selected epidemiologic features of this disease are reviewed along with the major nongonococcal pathogens and their treatment, and several theories of microbial etiology are summarized. The late sequelae from this disease are also described. Conventional techniques of diagnosing acute PID seem to be imprecise when applied to nongonococcal PID. Its clinical presentation is often unlike gonococcal PID, but signs and symptoms frequently lead to incorrect diagnosis. Most studies of acute PID lack an objective case definition. Some authors advocate wider use of laparoscopy in diagnosing acute PID, but cost remains an important limitation. The visual criteria for diagnosing PID may be so stringent that mild or early cases of endosalpingitis are missed. The external appearance of the fallopian tube may not be an accurate reflection of pathology involving the lumen. The bacteriology of acute PID seems to vary geographically. The time when the patient seeks medical attention for PID may influence the results of bacteriologic studies. The recovery rates for potential pathogens in acute PID may not accurately reflect the microbial etiology. There may be errors of underdiagnosis and overdiagnosis. In 1976, over 229,000 cases of gonorrhea associated with PID were reported in the U.S., and at least as many nongonococcal cases were estimated to have occurred. Most studies of the epidemiology of acute PID have not distinguished between gonococcal and nongonococcal disease. In the U.S., nongonococcal anaerobic and aerobic bacteria can be isolated from 46-90% of culdocentesis or laparotomy specimens of patients with acute nongonococcal PID. Experiments with grivet monkeys support an etiologic role for chlamydia trachomatis in acute PID. Mycoplasmas are widely found in the genital tracts of sexually active women, but their role in causing acute PID appears less certain than that of chlamydia trachomatis. Actinomycosis represents a unique nongonococcal PID related to IUD use. The optimal treatment for nongonococcal PID is unknown, but tetracycline and its derivatives are effective against a broad spectrum of nongonococcal organisms. Abscesses and infertility are serious complications of nongonococcal PID. Continued research needs to clarify the epidemiology, treatment, and prevention of this important disease." @default.
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• W2039291136 date "1981-12-01" @default.
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• W2039291136 title "NONGONOCOCCAL PELVIC INFLAMMATORY DISEASE" @default.
• W2039291136 doi "https://doi.org/10.1097/00003081-198112000-00019" @default.
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