N Engl J Med. Clin Infect Dis. J Med Microbiol. Sex Transm Dis. Wolfram Research Inc: Mathematica Edition. Smith KJ, Cook RL, Roberts MS: Time from sexually transmitted infection acquisition to pelvic inflammatory disease development: influence on the cost-effectiveness of different screening intervals. Value Health. Obstet Gynecol.
Am J Epidemiol. Sex Transm Infect. Rank RG, Sanders MM, Patton DL: Increased incidence of oviduct pathology in the guinea pig after repeat vaginal inoculation with the chlamydial agent of guinea pig inclusion conjunctivitis.
Am J Prev Med. National Chlamydia Screening Programme,. Download references. The views and opinions in this article are those of the authors and do not necessarily reflect those of the funders.
You can also search for this author in PubMed Google Scholar. Correspondence to Sereina A Herzog. SAH programmed the model and wrote the first draft of the paper. All authors commented on the manuscript and approved the final version.
This article is published under license to BioMed Central Ltd. Reprints and Permissions. Herzog, S. Timing of progression from Chlamydia trachomatis infection to pelvic inflammatory disease: a mathematical modelling study.
BMC Infect Dis 12, Download citation. Received : 01 February Accepted : 25 July Published : 11 August Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative.
Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background Pelvic inflammatory disease PID results from the ascending spread of microorganisms from the vagina and endocervix to the upper genital tract. Methods We develop a compartmental model that describes the trial structure of a published randomised controlled trial RCT and allows each of the three processes to be examined using the same model structure.
Results The predicted cumulative incidence of PID cases from all causes after one year depends on the fraction of chlamydia infected women that progresses to PID and on the type of progression.
Conclusions The findings of this study suggest that clinical PID can occur throughout the course of a chlamydia infection, which will leave a window of opportunity for screening to prevent PID.
Figure 1. Full size image. Table 1 Parameter values describing the natural history of chlamydia infection, PID development and the screening intervention Full size table. Figure 2. Table 2 Estimated fraction progressing from chlamydia infection to PID, using baseline values Full size table. Figure 3. Discussion and conclusion This study used a mathematical model to simulate the results of a randomised controlled trial of a chlamydia screening intervention.
References 1. Google Scholar 2. PID is an infection of a woman's reproductive organs. The reproductive organs include the uterus womb , fallopian tubes , ovaries , and cervix.
PID can be caused by many different types of bacteria. Sometimes PID is caused by normal bacteria found in the vagina. A woman can get PID if bacteria move up from her vagina or cervix and into her reproductive organs. Many different types of bacteria can cause PID. The number of women with PID has dropped in recent years. This may be because more women are getting tested regularly for chlamydia and gonorrhea.
Normal bacteria in the vagina can travel into a woman's reproductive organs and can sometimes cause PID. Sometimes the bacteria travel up to a woman's reproductive organs because of douching. Do not douche. No doctor or nurse recommends douching. Many women do not know they have PID because they do not have any signs or symptoms. When symptoms do happen, they can be mild or more serious. If you think that you may have PID, see a doctor or nurse as soon as possible.
These can include: 4. A Pap test is not used to detect PID. Your doctor or nurse will give you antibiotics to treat PID. Most of the time, at least two antibiotics are used that work against many different types of bacteria. You must take all of your antibiotics, even if your symptoms go away. This helps to make sure the infection is fully cured. See your doctor or nurse again two to three days after starting the antibiotics to make sure they are working.
If you still have symptoms or if the abscess does not go away after treatment, you may need surgery. Problems caused by PID, such as chronic pelvic pain and scarring, are often hard to treat.
But sometimes they get better after surgery. Without treatment, PID can lead to serious problems like infertility , ectopic pregnancy , and chronic pelvic pain pain that does not go away. Sexually Transmitted Diseases, 3rd Edition. New York: McGraw-Hill, , Skip directly to site content Skip directly to page options Skip directly to A-Z link.
Section Navigation. Facebook Twitter LinkedIn Syndicate. Minus Related Pages. Untreated sexually transmitted diseases STDs can cause pelvic inflammatory disease PID , a serious condition, in women. You can prevent PID if you know how to protect yourself. Basic Fact Sheet Detailed Version Basic fact sheets are presented in plain language for individuals with general questions about sexually transmitted diseases.
STDs Home Page. See Also Pregnancy Reproductive Health. A number of different microorganisms can cause or contribute to PID. The sexually transmitted pathogens C. Tubo-ovarian abscess TOA is a serious short-term complication of PID that is characterized by an inflammatory mass involving the fallopian tube, ovary, and, occasionally, other adjacent pelvic organs.
Treatment includes broad-spectrum antibiotics with or without a drainage procedure, with surgery often reserved for patients with suspected rupture or who fail to respond to antibiotics. Recurrent episodes of PID and increased severity of tubal inflammation detected by laparoscopy are associated with greater risk of infertility following PID.
PID is a frequent and important infection that occurs among women of reproductive age. The prevalence was highest in women at increased risk, such as those with previous sexually transmitted infections STIs. The significant burden of disease attributed to PID comes predominantly from the long-term reproductive sequelae of tubal infection: tubal factor infertility, ectopic pregnancy, and pelvic adhesions, which can lead to chronic pelvic pain.
Our knowledge of the longitudinal outcomes for affected women who experience PID is primarily derived from data published using a Scandinavian cohort of inpatients diagnosed with PID.
Generally there have been several studies published suggesting overall declines in PID diagnosis in both hospital and ambulatory settings, however some of these same studies have noted a possible increase in PID starting in The wide variation in symptoms and signs associated with PID can make diagnosis challenging. No single historical, physical, or laboratory finding is both sensitive and specific for the diagnosis of PID.
Clinicians should therefore maintain a low threshold for the diagnosis of PID, particularly in young, sexually active women. Presumptive treatment for PID should be initiated in sexually active young women and other women at risk for STDs if they are experiencing pelvic or lower abdominal pain, if no cause for the illness other than PID can be identified, and if one or more of the following minimum clinical criteria are present on pelvic examination:.
The requirement that all three minimum criteria be present before the initiation of empiric treatment could result in insufficient sensitivity for the diagnosis of PID. After deciding whether to initiate empiric treatment, clinicians should also consider the risk profile for STDs.
More elaborate diagnostic evaluation frequently is needed because incorrect diagnosis and management of PID might cause unnecessary morbidity.
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