Clinical Features
Pelvic Inflammatory Disease (PID)
The symptoms of PID are not very specific, which can make diagnosis very difficult. The disease can flare up suddenly, with symptoms including fever, abdominal pain, and vomiting. This can be acute PID, but many other illnesses present with the same or similar symptoms. Alternatively, it can rumble on as a chronic condition, with symptoms including pelvic pain and fatigue.
Approximately 50-80% of women of women infected with gonorrhoea have only mild symptoms, and about 70% of women infected with Chalamydia never have any symptoms.
However, possible warning signs of chronic PID include:-
- a thick vaginal discharge
- bleeding between periods
- heavier periods than usual
- pain in the lower back and lower abdomen
- uncomfortable or painful intercourse
- a slight intermittent fever
- pain in the rectum (back passage)
Any woman who has any of the above described symptoms should seek medical advice, although they should not assume that they have PID, and the doctor will need to carry out a variety of tests.
Acute salpingitis
Acute salpingitis causes pain and tenderness in the lower abdomen, and possibly slight distension. The temperature rises and may reach 40 degrees C, causing a raised pulse rate and rigors. The infection is usually bilateral, that is, it affects both tubes. Vomiting is unusual, a distinguishing feature from appendicitis, with which it can be easily confused. There is usually a vaginal discharge.
Chronic salpingitis
Chronic Salpingitis is a sequel to acute attacks. The original infection may have been of very mild character, or mild infections may have occurred on several occasions.
There may be irregular attacks of severe pain associated with heavy irregular periods and vaginal discharge. The pain tends to be worse before periods. Recurrent sub-acute attacks with fever are frequent. The worrying long-term complication of this condition is infertility due to inflammation and consequent fibrosis causing the fallopian tubes to block.
Amended June 2008
