Response to Letter by Cheong Regarding Article, “Association Between Stroke and Patients With Pelvic Inflammatory Disease: A Nationwide Population-Based Study in Taiwan”

Abstract

Response: We thank Dr. Cheong for his careful reading of and suggestions for our articles.1 The clinical diagnosis of pelvic inflammatory disease (PID) is notoriously difficult.2 Subclinical PID, acute PID, chronic PID, and tubo-ovarian abscess (TOA) were indicated as upper genital infection in female reproductive system. In clinical experience, PID is usually accompanied by lower genital tract infection. In pathological experience, PID is a polymicrobial infection heralded by the acquisition of a sexually transmitted pathogen and results in increasing spread of aerobic and anaerobic vaginal bacteria.3 The original idea of this study was to evaluate the impact of female genital tract infection on the prevalence of stroke. Furthermore, bacterial vaginosis, a common lower-genital infection, is not associated with PID, but specific subgroups of patients with bacterial vaginosis that may be difficult to identify clinically are at increased risk for PID.4 All ICD-9-CM codes 614 to …