Diagnosis Of Pelvic Inflammatory Disease Research Articles

Syphilis and pelvic inflammatory disease.

Since screening every patient in the emergency department for venereal disease is impractical, we hypothesized that patients with the clinical diagnosis of pelvic inflammatory disease (PID) might be at higher risk and a group that should be screened. Seventy women with a clinical diagnosis of PID treated in our adult emergency department from July to November 1976 were screened for syphilis using three separate serologic tests: Venereal Disease Research Laboratory, fluorescent treponemal antibody absorption, and treponema pallidum hemagglutination. The incidence of positive serologies in our study group was significantly higher (11.4%) than that of 100 controls (4%). All patients with a clinical diagnosis of PID should be screened for syphilis using both FTA-Abs and TPHA tests, as well as a VDRL.

Doxycycline (Vibramycin®) in Pelvic Inflammatory Disease

Using standardized laparoscopy technique, fluid was aspirated from the pouch of Douglas, from the Fallopian tubes and from ovarian cysts in 85 cases with clinical diagnosis of pelvic inflammatory disease (PID). The concentration of doxycycline in the aspirates was measured after oral ingestion of 200 mg of doxycycline (Vibramycin). A therapeutic level was achieved in the tubes and in ovarian cysts within a few hours, and on continuation of the treatment these values followed the plasma concentration closely, still being within the therapeutic range 24 hours after the final dose. The clinical effect was excellent, 94% (60/64) of the cases with verified PID being cured by doxycycline.

Torsion of the oviduct following laparoscopic sterilization

A case report of tubal torsion following laparoscopic sterilization is presented. The patient was examined following the sudden onset of ab dominal pain and a presumptive diagnosis of pelvic inflammatory disease was made for which ampicillin was prescribed. However the pain persisted and exploratory laparotomy was performed. Examination reveale d complete torsion of the distal portion of the right oviduct and distension to a length of 10 cm and a diameter of 5 cm. Symptoms disapp eared following a right salpingectomy and appendectomy. In this case it is suspected that tubal torsion was the result of cutting too deeply into the mesosalpinx. Factors which may contribute to the etiology of tubal torsion are reviewed.

The bacteriology of acute pelvic inflammatory disease: Value of cul-de-sac cultures and relative importance of gonococci and other aerobic or anaerobic bacteria

The bacteriology of acute pelvic inflammatory disease (PID) was studied in 20 patients by simultaneous cul-de-sac, cervical, and blood cultures with aerobic and fastidious anaerobic techniques. Cul-de-sac cultures were positive in 18 of 20 patients, while all 8 normal control subjects yielded negative results (p < 0.0005, chi-square analysis). Anaerobic bacteria (predominantly Peptococcus and Peptostreptococcus) were present in 10 patients (59 per cent), and they were the exclusive isolates in 3 patients. N. gonorrhoeae was isolated only once from the cul-de-sac despite its presence in cervical specimens. There was poor correlation between cul-de-sac and cervical cultures. Cervical cultures yielded a variety of aerobic and anaerobic bacteria with an average of 3.8 organisms per specimen. N. gonorrhoeae was isolated in 13 patients (65 per cent). Only 19 per cent of cervical isolates were recovered by culdocentesis; similarly, only 31 per cent of cul-de-sac isolates were simultaneously isolated from the cervix. Blood cultures were uniformly negative. These data suggest that: (1) culdocentesis is a reliable technique for the bacteriologic diagnosis of acute PID, and (2) whereas the gonococcus may be important in initiating acute PID, its primary role appears to be paving the way for secondary invaders from the normal vaginal flora to gain access to the upper genital tract.

Infection and the IUD: A preliminary report

This is a preliminary report to answer the question: “Does the IUD increase the incidence of pelvic infection?” From one hospital, the percentage of young women with a discharge diagnosis of Pelvic Inflammatory Disease (PID) who were wearing an IUD at the time of admission was calculated. With precisely the same definitions, the percentage of young women utilizing an IUD who were discharged from the same hospital as having had appendicitis was determined. Thus far, a statistically significant correlation between IUD usage and P.I.D. could not be demonstrated. A larger study is current.

Acute pelvic inflammatory disease and clinical response to parenteral doxycycline.

The bacteriology of acute pelvic inflammatory disease (PID) and clinical response to parenteral doxycycline were evaluated in 30 patients. Only 3 of 21 cul-de-sac cultures from PID patients were sterile, whereas all 8 normal control subjects yielded negative results (P< 0.005). Poor correlation was observed between cervical and cul-de-sac cultures. Neisseria gonorrhoeae, isolated from the cervix in 17 patients (57%), was recovered from the cul-de-sac only once. Streptococcus, Peptococcus, Peptostreptococcus, coliforms, and other organisms normally present in the vagina were the predominant isolates recovered from the cul-de-sac. Parenteral doxycycline resulted in rapid resolution of signs and symptoms (within 48 h) in 20 of 27 evaluable patients (74%). In five others, signs and symptoms of infection abated within 4 days. The remaining two patients failed to respond; in both cases, adnexal masses developed during doxycycline therapy. Gonococci were eradicated from the cervix in all but one patient who, nevertheless, had a rapid defervescence of symptoms. There was no clear-cut correlation between the clinical response and in vitro susceptibility of cul-de-sac isolates to doxycycline. These data confirm the usefulness of broad-spectrum antibiotics in acute PID. Culdocentesis is a reliable means of obtaining material for the bacteriological diagnosis of acute PID; however, the pathogenetic role and relative importance of gonococci and various other bacteria in acute PID need to be clarified further.

Clinical infections detected by 67Ga scanning.

Gallium-67 was utilized in 34 patients suffering from clinically demonstrable infections. The isotope was able to localize infections in soft tissue, bones, and some areas of the abdomen. Its utilization in the diagnosis of pelvic inflammatory disease is complicated by the fact that the isotope is secreted into the bowel and obscures the area. This isotope is ideal for the diagnosis of acute and/or chronic inflammation of bone secondary to open reduction of fractures, and may also be of use in the diagnosis of primary osteomyelitis.

Alarming neuromuscular reactions due to prochlorperazine.

Article1 March 1960ALARMING NEUROMUSCULAR REACTIONS DUE TO PROCHLORPERAZINEJANIS GAILITIS, M.D., RICHARD R. KNOWLES, M.D., ARTURO LONGOBARDI, M.D.JANIS GAILITIS, M.D.Search for more papers by this author, RICHARD R. KNOWLES, M.D.Search for more papers by this author, ARTURO LONGOBARDI, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-52-3-538 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptPeculiar aneuromuscular reactions of the dystonic type have been reported as infrequent side-effects of prochlorperazine therapy.1 This so-called extrapyramidal syndrome presents a frightening experience to the patient and a diagnostic challenge for the physician. Four such episodes were observed in Newport Hospital in the years 1958-1959.CASE REPORTSCase 1. A 25 year old white female was admitted on April 19, 1958, with low abdominal pain, fever and vomiting. She had been discharged 12 days previously after a dilatation and curettage for diagnostic purposes. A tentative diagnosis of pelvic inflammatory disease was made, and treatment with parenteral penicillin and streptomycin...Bibliography1. EnglandSchwabb ACRS: The management of Parkinson's disease, Arch. Int. Med. 104: 439-468, 1959. CrossrefMedlineGoogle Scholar2. DelayDenikerGreenMordret JPAM: Le syndrome excitomoteur provoqué par les medicaments neuroleptiques, Presse méd. 65: 1771-1774, 1957. MedlineGoogle Scholar3. O'Hara VS: Extrapyramidal reactions in patients receiving prochlorperazine, New England J. Med. 259: 826-828, 1958. CrossrefMedlineGoogle Scholar4. ChristianPaulson CDG: Severe motility disturbance after small dose of prochlorperazine, New England J. Med. 259: 826-830, 1958. CrossrefMedlineGoogle Scholar5. GraffPhillipsGentry TDOCWD: Clonic convulsions after the oral use of perphenazine (Trilafon), J. A. M. A. 169: 834-835, 1959. CrossrefMedlineGoogle Scholar6. Graham GK: Severe side reaction to therapeutic dosage of perphenazine, New England J. Med. 260: 1133, 1959. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication November 6, 1959.From Newport Hospital, Newport, Rhode Island.†Available as Compazine from Smith, Kline and French Laboratories, Philadelphia.Requests for reprints should be addressed to Richard R. Knowles, M.D., 230 Bellevue Avenue, Newport, Rhode Island. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAcute dystonic reactions from “Street valium”Extended therapy for acute dystonic reactionsAntiparkinsonian and antidyskinetic drugsSerious reactions to phenothiazinesA Comparison of Chlorpromazine-Induced Extrapyramidal Syndrome in Male and Female RatsHYSTERIA AND DRUG-INDUCED DYSTONIAPhenothiazinesPhenothiazine BibliographiesUnusual Manifestations Associated with a Phenothiazine-Induced Dystonic ReactionPhenothiazine und Azaphenothiazine als Heilmittel 1 March 1960Volume 52, Issue 3Page: 538-543KeywordsAbdominal painFeversPathogenesisPelvic inflammatory diseasePenicillinSchizophreniaSedationStreptomycinVomiting Issue Published: 1 March 1960 PDF downloadLoading ...