Teaching Case

Dyspareunia Purulent vaginal discharge

Dyspareunia Purulent vaginal discharge

PELVIC INFLAMMATORY DISEASE This condition is defined as an acute clinical syndrome associated with ascending spread of micro-organisms, unrelated to pregnancy or surgery, from the vagina or cervix to the endometrium, fallopian tubes and / or contiguous structures. Highest incidence of PID is seen among sexually active women in their teens, with 75% cases being under 25 years of age. The commonest organisms responsible are Chlamydia trachomatis and Neisseria gonnorrhoeae (60%). Actinomycotic PID is confined to women using intrauterine contraception. Awareness of this curable, but potentially lethal condition, will aid diagnosis. Radiological findings are non-specific but are out of proportion to what may be apparent from symptomatology. CT shows diffusely enhancing ill-defined pelvic mass which may be difficult to differentiate from malignancy. MR imaging yields a better insight into the pattern of spread.