Clinical characteristics of genital chlamydia infection in pelvic inflammatory disease

Sung Taek Park,Young Mo Kang,Chae Chun Rhim,Hye Min Moon,Suk Woo Lee,Min Jeong Kim

doi:10.1186/s12905-016-0356-9

Sung Taek Park, Young Mo Kang + Show 4 more

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https://doi.org/10.1186/s12905-016-0356-9

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Abstract

BackgroundChlamydia infection in acute pelvic inflammatory disease (PID) is associated with serious complications including ectopic pregnancy, tubal infertility, Fitz-Hugh-Curtis syndrome and tubo-ovarian abscess (TOA). This study compared clinical and laboratory data between PID with and without chlamydia infection.MethodsThe medical records of 497 women who were admitted with PID between 2002 and 2011 were reviewed. The patients were divided into two groups (PID with and without chlamydia infection), which were compared in terms of the patients’ characteristics, clinical presentation, and laboratory findings, including inflammatory markers.ResultsThe chlamydia and non-chlamydia groups comprised 175 and 322 women, respectively. The patients in the chlamydia group were younger and had a higher rate of TOA, a longer mean hospital stay, and had undergone more surgeries than the patients in the non- chlamydia group. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and CA-125 level were higher in the chlamydia group than in the non-chlamydia group, but there was no significant difference in the white blood cell count between the two groups. The CA-125 level was the strongest predictor of chlamydia infection, followed by the ESR and CRP level. The area under the receiving operating curve for CA-125, ESR, and CRP was 0.804, 0.755, and 0.663, respectively.ConclusionsChlamydia infection in acute PID is associated with increased level of inflammatory markers, such as CA-125, ESR and CRP, incidence of TOA, operation risk, and longer hospitalization.

Highlights

Chlamydia infection in acute pelvic inflammatory disease (PID) is associated with serious complications including ectopic pregnancy, tubal infertility, Fitz-Hugh-Curtis syndrome and tubo-ovarian abscess (TOA)
Participants We reviewed the medical records of 1,422 women diagnosed with PID, salpingitis, endometritis, Fitz-Hugh-Curtis syndrome (FHCS), or a TOA, who were treated at St
Among the 497 females diagnosed with acute PID, 175 (35.2%) and 322 (64.8%) were in the chlamydia and non-chlamydia groups, respectively

Summary

Introduction

Chlamydia infection in acute pelvic inflammatory disease (PID) is associated with serious complications including ectopic pregnancy, tubal infertility, Fitz-Hugh-Curtis syndrome and tubo-ovarian abscess (TOA). The polymicrobial etiology of PID can be delineated artificially into sexually transmitted infections that colonize the upper genital tract, including Chlamydia trachomatis, Neisseria gonorrhoeae, and endogenous microorganisms found in the vagina, anaerobic bacteria such as Gardnerella vaginalis, Haemophilus influenzae, enteric Gram-negative rods, and Streptococcus agalactiae [3, 4]. Chlamydia infection is associated with a wide spectrum of upper genital tract pathologies, ranging from asymptomatic endometritis to symptomatic salpingitis, peritonitis, tubo-ovarian abscess (TOA), Fitz-Hugh-Curtis syndrome (FHCS) characterized by inflammation in perihepatic capsules, and longterm sequelae such as infertility, ectopic pregnancy, and chronic pelvic pain [6,7,8]. Prompt treatment and screening for chlamydia infections in women of reproductive age is essential to prevent severe damage to the reproductive organs; Park et al BMC Women's Health (2017) 17:5 chlamydia screening and treatment programs have been implemented in many countries [10]

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