A Case of Mayer-Rokitansky-Küster-Hauser Syndrome

Abstract

Pelvic inflammatory disease (PID) is an infection of the upper genital tract in women. The spectrum of disease ranges from asymptomatic infection to lifethreatening illness. Sequelae include chronic pelvic pain, ectopic pregnancy, and infertility. PID is diagnosed clinically. Laboratory and imaging studies are reserved for patients who have an uncertain diagnosis. The Centers for Disease Control and Prevention diagnostic criteria include uterine, adnexal, or cervical motion tenderness with no other obvious cause in women at risk of PID. Empiric treatment should be initiated promptly and must cover Chlamydia trachomatis and Neisseria gonorrhoeae. The possibility of fluoroquinolone-resistant N. gonorrhoeae also should be considered. Therefore, hospitalization is recommended only when the diagnosis is uncertain, pelvic abscess is suspected, clinical disease is severe, or compliance with an outpatient regimen is in question. Patients also should be hospitalized if a surgical emergency cannot be excluded or if no clinical improvement occurs after three days. Routine screening for asymptomatic chlamydial infection can help prevent PID.