Non-Sexual Pelvic Inflammatory Disease in a Virginal Patient Resulting in Catatonic Conversion Reaction

Abstract

Abstract Background: Pelvic inflammatory disease (PID) could result in long-term gynecologic sequelae, including chronic pelvic pain, infertility, and ectopic pregnancy. Most cases are associated with sexually transmitted infections, with the diagnosis often overlooked in virginal patients. The purpose of this case report is to highlight PID as a diagnostic possibility even in virginal females who have risk factors for its occurrence. In this case, the diagnosis and subsequent treatment were complicated by the patient's psychogenic, altered mental status. Case: A 43-year-old gravida 0, virginal, African-American patient, with a history of douching, presented with lower pelvic pain and fever 2 weeks after her last menstrual period. Her physical examination was compatible with PID; douching was her isolated risk factor for upper genital–tract infection. After laparoscopic tubal drainage, the patient lapsed into a catatonic state. Results: Laboratory data revealed leukocytosis; transvaginal ultrasound reveal...