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1.
Clin Lab ; 70(3)2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38469774

RESUMO

BACKGROUND: The goal is to assess the role of immature granulocytes (IG) in the diagnosis of acute pelvic-inflammatory-disease (PID) and to determine whether they are useful for discriminating mild/moderate and severe PID. METHODS: Patients admitted with the diagnosis of acute PID were retrospectively assessed. Diagnosis was based on CDC criteria. Patients were grouped as severe and mild/moderate PID based on need for hospitalization. Control group consisted of patients in whom PID was excluded by laparoscopy. Sample size was calculated with statistical methods. IGs were compared within the groups. Cutoff values were determined for prediction of diagnosis and severity of acute PID. RESULTS: There were 74 severe, 32 mild/moderate acute PID, and 41 control patients. Thirty patients had surgery following no response to antibiotic treatment or tubo-ovarian abscess. IGs were significantly higher in the severe group compared to mild/moderate and control groups. ROC analysis showed IG counts (≥ 0.035 µL) and percentages (≥ 0.35%) were significantly effective in predicting acute PID and were associated with severity when they were ≥ 0.055 µL and ≥ 0.42%, respectively. IG count ≥ 0.085 was found to have 58.6% sensitivity and 63.1% speci-ficity for prediction of surgical intervention need. CONCLUSIONS: IGs are components of simple CBC tests and are easily obtainable, cheap markers. They were found to be elevated in acute PID and correlated significantly with the severity of the disease. These markers may serve as adjunctive markers for the diagnosis of acute PID and may be useful in discrimination between mild/moderate and severe PID.


Assuntos
Doença Inflamatória Pélvica , Feminino , Humanos , Doença Inflamatória Pélvica/diagnóstico , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/cirurgia , Estudos Retrospectivos , Antibacterianos/uso terapêutico , Hospitalização , Granulócitos , Doença Aguda
2.
Med Clin North Am ; 108(2): 297-310, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38331481

RESUMO

Mycoplasma genitalium (MG) is an emerging sexually transmitted infection, which appears to be a cause of urethritis and cervicitis and has been associated with pelvic inflammatory disease (PID), epididymitis, proctitis, infertility, complications during pregnancy, and human immunodeficiency virus (HIV) transmission. Three Food and Drug Administration (FDA) approved tests are available. Testing should be focused to avoid inappropriate antibiotic use. The Center of Disease Control and Prevention (CDC) guidelines recommend testing for persistent male urethritis, cervicitis, and proctitis and state that testing should be considered in cases of PID. Testing is also recommended for sexual contacts of patients with MG. Testing is not recommended in asymptomatic patients, including pregnant patients, who do not have a history of MG exposure. Although resistance-guided therapy is recommended, there are currently no FDA approved tests for MG macrolide resistance, and tests are not widely available in the United States. The CDC recommends 2-step treatment with doxycycline followed by azithromycin or moxifloxacin. Moxifloxacin is recommended if resistance testing is unavailable or testing demonstrates macrolide resistance..


Assuntos
Infecções por Mycoplasma , Mycoplasma genitalium , Doença Inflamatória Pélvica , Proctite , Uretrite , Cervicite Uterina , Gravidez , Feminino , Humanos , Masculino , Antibacterianos/uso terapêutico , Antibacterianos/farmacologia , Uretrite/diagnóstico , Uretrite/tratamento farmacológico , Uretrite/complicações , Moxifloxacina/uso terapêutico , Cervicite Uterina/complicações , Cervicite Uterina/tratamento farmacológico , Macrolídeos/uso terapêutico , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/tratamento farmacológico , Infecções por Mycoplasma/complicações , Farmacorresistência Bacteriana , Doença Inflamatória Pélvica/diagnóstico , Doença Inflamatória Pélvica/tratamento farmacológico , Doença Inflamatória Pélvica/complicações , Proctite/complicações , Proctite/tratamento farmacológico , Atenção Primária à Saúde
3.
Zhongguo Zhen Jiu ; 44(2): 134-138, 2024 Feb 12.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-38373756

RESUMO

OBJECTIVES: To compare the clinical effect between inverted T-shaped herb-separated moxibustion combined with western medication and simple western medication on chronic pelvic pain(CPP)in sequelae of pelvic inflammatory diseases. METHODS: A total of 60 patients with CPP in sequelae of pelvic inflammatory diseases were randomly divided into an observation group and a control group, 30 cases in each group. The control group was given ibuprofen tablets 10 days before menstruation, 0.2 g each time, once a day for 10 days. After menstruation, the medication was stopped, and the treatment was given for 3 menstrual cycles.On the basis of the treatment in the control group, the observation group was treated with inverted T-shaped herb-separated moxibustion at the connection between Zhongwan(CV 12)and Zhongji(CV 3), and the connection between Zigong(EX-CA 1)on both sides.The treatment was performed once a week, with an interval of 6 days. The moxibustion was stopped during the menstrual period, the treatment was given for 3 menstrual cycles.Before and after treatment, the visual analogue scale(VAS)score of lower abdominal and lumbosacral pain, local symptom (uterine tenderness, adnexal tenderness and uterosacral ligament tenderness) score and quality of life assessment (QOL) score of the two groups were observed. RESULTS: After treatment, the lower abdominal and lumbosacral pain VAS scores, the local symptom scores of uterine tenderness, adnexal tenderness, uterosacral ligament tenderness and total scores in the two groups were lower than those before treatment(P<0.01).The lower abdominal and lumbosacral pain VAS score in the observation group was lower than that in the control group(P<0.01),and the changes of local symptom scores of uterine tenderness, adnexal tenderness and uterosacral ligament tenderness and total score in the observation group were greater than those in the control group(P<0.01). After treatment, the QOL scores of the two groups were higher than those before treatment(P<0.01), and the score in the observation group was higher than that in the control group(P<0.01). CONCLUSIONS: Inverted T-shaped herb-separated moxibustion combined with western medication can effectively reduce the pain in patients with CPP in sequelae of pelvic inflammatory diseases, relieve the local symptoms, improve the quality of life, and the curative effect is better than western medication alone.


Assuntos
Moxibustão , Doença Inflamatória Pélvica , Feminino , Humanos , Qualidade de Vida , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/terapia , Ibuprofeno , Dor Pélvica/etiologia , Dor Pélvica/terapia , Pontos de Acupuntura , Resultado do Tratamento
4.
Jpn J Radiol ; 42(4): 331-346, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38165529

RESUMO

This review focuses on inflammatory diseases of female and male genital organs and discusses their epidemiology, pathogenesis, clinical presentation, and imaging findings. The female section covers pelvic inflammatory disease (PID) primarily caused by sexually transmitted infections (STIs) that affect the uterus, fallopian tubes, and ovaries. Unusual causes such as actinomycosis and tuberculosis have also been explored. The male section delves into infections affecting the vas deferens, epididymis, testes, prostate, and seminal vesicles. Uncommon causes such as tuberculosis, and Zinner syndrome have also been discussed. In addition, this review highlights other conditions that mimic male genital tract infections such as vasculitis, IgG4-related diseases, and sarcoidosis. Accurate diagnosis and appropriate management of these inflammatory diseases are essential for preventing serious complications and infertility. Imaging modalities such as ultrasound, magnetic resonance imaging, and computed tomography play a crucial role in diagnosis. Understanding the diverse etiologies and imaging findings is vital for the effective management of inflammatory diseases of the genital organs.


Assuntos
Doença Inflamatória Pélvica , Tuberculose , Masculino , Humanos , Feminino , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/diagnóstico , Genitália/diagnóstico por imagem , Útero , Próstata , Tuberculose/complicações
5.
PLoS One ; 19(1): e0292166, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38295033

RESUMO

BACKGROUND: Studies investigating the effectiveness of acupuncture therapies in alleviating pain in pelvic inflammatory disease (PID) have gained increasing attention. However, to date, there have been no systematic reviews and meta-analyses providing high-quality evidence regarding the efficacy and safety of acupuncture therapies in this context. OBJECTIVE: The objective of this review was to assess the efficacy and safety of acupuncture therapies as complementary or alternative treatments for pain relief in patients with PID. METHOD: A comprehensive search was conducted in eight databases from inception to February 20, 2023: PubMed, Embase, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and Chinese Biomedical Literature Database. Randomized controlled trials (RCTs) investigating acupuncture therapies as complementary or additional treatments to routine care were identified. Primary outcomes were pain intensity scores for abdominal or lumbosacral pain. The Cochrane risk of bias criteria was applied to assess the methodological quality of the included trials. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system was used to evaluate the quality of evidence. Data processing was performed using RevMan 5.4. RESULT: This systematic review included twelve trials comprising a total of 1,165 patients. Among these, nine trials examined acupuncture therapies as adjunctive therapy, while the remaining three did not. Meta-analyses demonstrated that acupuncture therapies, whether used alone or in combination with routine treatment, exhibited greater efficacy in relieving abdominal pain compared to routine treatment alone immediately after the intervention (MD: -1.32; 95% CI: -1.60 to -1.05; P < 0.00001). The advantage of acupuncture therapies alone persisted for up to one month after the treatment (MD: -1.44; 95% CI: -2.15 to -0.72; P < 0.0001). Additionally, acupuncture therapies combined with routine treatment had a more pronounced effect in relieving lumbosacral pain after the intervention (MD: -1.14; 95% CI: -2.12 to -0.17; P < 0.00001) in patients with PID. The incidence of adverse events did not increase with the addition of acupuncture therapies (OR: 0.56; 95% CI: 0.21 to 1.51; P = 0.25). The findings also indicated that acupuncture therapies, as a complementary treatment, could induce anti-inflammatory cytokines, reduce pro-inflammatory cytokines, alleviate anxiety, and improve the quality of life in patients with PID. CONCLUSION: Our findings suggest that acupuncture therapies may effectively reduce pain intensity in the abdomen and lumbosacral region as complementary or alternative treatments, induce anti-inflammatory cytokines, decrease pro-inflammatory cytokines, alleviate anxiety, and enhance the quality of life in patients with PID, without increasing the occurrence of adverse events. However, due to the low quality of the included trials, the conclusion should be interpreted with caution, highlighting the need for further high-quality trials to establish more reliable conclusions.


Assuntos
Terapia por Acupuntura , Doença Inflamatória Pélvica , Feminino , Humanos , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/terapia , Terapia por Acupuntura/efeitos adversos , Dor/etiologia , Anti-Inflamatórios , Citocinas
6.
J Womens Health (Larchmt) ; 33(1): 73-79, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37851499

RESUMO

Background: Endometriosis is a common chronic disorder, which leads to dysmenorrhea, dyspareunia, pelvic chronic pain, and infertility. It affects ∼6% to 10% of the general female population. However, the etiology of endometriosis remained unclear. We aimed to systematically assess the association between pelvic inflammatory disease (PID) and the risk of endometriosis. Materials and Methods: Eligible studies published until May 21, 2022, were retrieved from the PubMed, EMBASE, and Web of Science databases. The studies were included based on the following criteria: (1) original articles on the association between PID and risk of endometriosis; (2) randomized controlled trials and cross-sectional, case-control, and cohort studies; and (3) studies involving humans. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of the studies included in this systematic review. The association between PID and risk of endometriosis was evaluated using the overall odds ratio (OR) and correlative 95% confidence interval (CI). Results: The meta-analysis included 14 studies with 747,733 patients. The mean prevalence of PID in women with endometriosis was 33.80%. Our quantitative synthesis revealed that endometritis was associated with a significantly increased risk of endometriosis (OR: 1.63, 95% CI: 1.53-1.74, I2 = 59%). Conclusion: We study a statistically significant association between PID and the risk of endometriosis. In particular, endometritis might play an important role in endometriosis, based on the lower heterogeneity of the subgroup analysis. This finding suggests that reducing the incidence of endometritis might aid in the prevention and treatment of endometriosis.


Assuntos
Endometriose , Endometrite , Doença Inflamatória Pélvica , Feminino , Humanos , Endometriose/complicações , Endometriose/epidemiologia , Doença Inflamatória Pélvica/epidemiologia , Doença Inflamatória Pélvica/complicações , Endometrite/complicações , Estudos Transversais , Dor Pélvica/epidemiologia , Dor Pélvica/etiologia
7.
BMC Public Health ; 23(1): 1894, 2023 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-37784046

RESUMO

BACKGROUND: Pelvic inflammatory disease (PID) is a widespread female public problem worldwide. And it could lead to infertility, preterm labor, chronic pelvic pain, and ectopic pregnancy (EP) among reproductive-aged women. This study aimed to assess the global burden and trends as well as the chaning correlation between PID and EP in reproductive-aged women from 1990 to 2019. METHODS: The data of PID and EP among reproductive-aged women (15 to 49 years old) were extracted from the Global Burden of Disease study 2019. The disease burden was assessed by calculating the case numbers and age-standardized rates (ASR). The changing trends and correlation were evaluated by calculating the estimated annual percentage changes (EAPC) and Pearson's correlation coefficient. RESULTS: In 2019, the ASR of PID prevalence was 53.19 per 100,000 population with a decreasing trend from 1990 (EAPC: - 0.50), while the ASR of EP incidence was 342.44 per 100,000 population with a decreasing trend from 1990 (EAPC: - 1.15). Globally, PID and EP burdens changed with a strong positive correlation (Cor = 0.89) globally from 1990 to 2019. In 2019, Western Sub-Saharan Africa, Australasia, and Central Sub-Saharan Africa had the highest ASR of PID prevalence, and Oceania, Eastern Europe, and Southern Latin America had the highest ASR of EP incidence. Only Western Europe saw significant increasing PID trends, while Eastern Europe and Western Europe saw increasing EP trends. The highest correlations between PID and EP burden were observed in Burkina Faso, Laos, and Bhutan. General negative correlations between the socio-demographic index and the ASR of PID prevalence and the ASR of EP incidence were observed at the national levels. CONCLUSION: PID and EP continue to be public health burdens with a strong correlation despite slightly decreasing trends detected in ASRs globally. Effective interventions and strategies should be established according to the local situation by policymakers.


Assuntos
Doença Inflamatória Pélvica , Gravidez Ectópica , Gravidez , Recém-Nascido , Feminino , Humanos , Adulto , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Doença Inflamatória Pélvica/epidemiologia , Doença Inflamatória Pélvica/complicações , Gravidez Ectópica/epidemiologia , Gravidez Ectópica/etiologia , Reprodução , Incidência , Australásia/epidemiologia , Carga Global da Doença , Saúde Global
8.
Am Fam Physician ; 108(2): 175-180, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37590858

RESUMO

Acute pelvic pain is defined as noncyclic, intense pain localized to the lower abdomen and/or pelvis, with a duration of less than three months. Signs and symptoms are often nonspecific. The differential diagnosis is broad, based on the patient's age and pregnancy status and gynecologic vs. nongynecologic etiology. Nongynecologic etiologies include gastrointestinal, urinary, and musculoskeletal conditions. Urgent gynecologic conditions include ectopic pregnancy, ruptured ovarian cyst, adnexal torsion, and pelvic inflammatory disease. Approximately 40% of ectopic pregnancies are misdiagnosed at the presenting visit. Urgent nongynecologic conditions include appendicitis and pyelonephritis. Less urgent etiologies include sexually transmitted infections, pelvic floor myofascial pain, dysmenorrhea, and muscle strain. Approximately 15% of untreated chlamydia infections lead to pelvic inflammatory disease. History and physical examination findings guide laboratory testing. Questions should focus on the type, onset, location, and radiation of pain; timing and duration of symptoms; aggravating and relieving factors; and associated symptoms. Performing a urine pregnancy test or beta human chorionic gonadotropin test is an important first step for sexually active, premenopausal patients. Imaging options should be considered, with transvaginal ultrasonography first, followed by computed tomography. Magnetic resonance imaging can be useful if ultrasonography and computed tomography are nondiagnostic.


Assuntos
Dor Aguda , Doença Inflamatória Pélvica , Gravidez Ectópica , Feminino , Humanos , Gravidez , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/diagnóstico , Dor Pélvica/diagnóstico , Dor Pélvica/etiologia , Dor Aguda/diagnóstico , Dor Aguda/etiologia , Gonadotropina Coriônica Humana Subunidade beta , Dismenorreia
9.
Adv Emerg Nurs J ; 45(3): 222-229, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37501275

RESUMO

Mycoplasma genitalium (MG) is a bacterium that can be spread through sexual contact with another person who is infected. If misdiagnosed and left untreated, this newer, emerging sexually transmitted infection (STI) can cause complications such as urethritis and pelvic inflammatory disease (PID) in both men and women. In males, MG can be asymptomatic and undetectable. In females, MG may present with nonspecific symptoms, such as dysuria, vaginal discharge, and/or pelvic pain. In addition to chlamydia and gonorrhea, MG may result in PID. Due to the complications of MG, health care providers in the emergency department setting need to consider this as a differential diagnosis when performing STI and vaginitis screenings on sexually active patients who may present with urinary or vaginal complaints. As patients with pelvic pain are frequently seen in the emergency department, providers need to be aware of the role that MG may play in STIs and the subsequent sequelae if not treated properly.


Assuntos
Infecções por Mycoplasma , Mycoplasma genitalium , Doença Inflamatória Pélvica , Infecções Sexualmente Transmissíveis , Masculino , Humanos , Feminino , Doença Inflamatória Pélvica/diagnóstico , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/microbiologia , Chlamydia trachomatis , Infecções por Mycoplasma/complicações , Infecções por Mycoplasma/diagnóstico , Infecções por Mycoplasma/microbiologia , Infecções Sexualmente Transmissíveis/complicações , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/microbiologia , Dor Pélvica
10.
J Womens Health (Larchmt) ; 32(9): 942-949, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37384920

RESUMO

Background: Gonorrhea incidence in the United States has risen by nearly 50% in the last decade, while screening rates have increased. Gonorrhea sequelae rates could indicate whether increased gonorrhea incidence is due to better screening. We estimated the association of gonorrhea diagnosis with pelvic inflammatory disease (PID), ectopic pregnancy (EP), and tubal factor infertility (TFI) in women and detected changes in associations over time. Materials and Methods: This retrospective cohort study included 5,553,506 women aged 18-49 tested for gonorrhea in the IBM MarketScan claims administrative database from 2013-2018 in the United States. We estimated incidence rates and hazard ratios (HRs) of gonorrhea diagnosis for each outcome, adjusting for potential confounders using Cox proportional hazards models. We tested the interaction between gonorrhea diagnosis and the initial gonorrhea test year to identify changes in associations over time. Results: We identified 32,729 women with a gonorrhea diagnosis (mean follow-up time in years: PID = 1.73, EP = 1.75, TFI = 1.76). A total of 131,500 women were diagnosed with PID, 64,225 had EP, and 41,507 had TFI. Women with gonorrhea diagnoses had greater incidence per 1000 person-years for all outcomes (PID = 33.5, EP = 9.4, TFI = 5.3) compared to women without gonorrhea diagnoses (PID = 13.9, EP = 6.7, TFI = 4.3). After adjustment, HRs were higher in women with a gonorrhea diagnosis vs. those without [PID = 2.29 (95% confidence interval, CI: 2.15-2.44), EP = 1.57, (95% CI: 1.41-1.76), TFI = 1.70 (95% CI: 1.47-1.97)]. The interaction of gonorrhea diagnosis and test year was not significant, indicating no change in relationship by initial test year. Conclusion: The relationship between gonorrhea and reproductive outcomes has persisted, suggesting a higher disease burden.


Assuntos
Infecções por Chlamydia , Gonorreia , Doença Inflamatória Pélvica , Gravidez Ectópica , Gravidez , Feminino , Estados Unidos , Humanos , Gonorreia/epidemiologia , Infecções por Chlamydia/epidemiologia , Estudos Retrospectivos , Chlamydia trachomatis , Gravidez Ectópica/epidemiologia , Gravidez Ectópica/etiologia , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/diagnóstico , Seguro Saúde
11.
J Med Case Rep ; 17(1): 166, 2023 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-37095582

RESUMO

BACKGROUND: A pyosalpinx is the acute inflammation of the fallopian tube, which fills up and swells with pus. It commonly results from inadequate or delayed treatment of pelvic inflammatory disease. CASE PRESENTATION: We report the case of a 54-year-old Africain female patient, who presented with sustained high-grade fever, right flank pain, and severe acute storage low-urinary-tract symptoms. Computed tomography showed signs of acute obstructive pyelonephritis with a right tubular juxtauterine mass with complex internal fluid and thick enhancing walls exerting a mass effect on the right ureter. A drainage of the right excretory cavities by a JJ stent was performed. An ultrasound-guided aspiration of the collection was also performed. CONCLUSION: A pyosalpinx can then exert a mass effect on the excretory cavities, thus causing an acute obstructive pyelonephritis. A double drainage coupled with an effective antibiotic therapy is then necessary.


Assuntos
Doença Inflamatória Pélvica , Pielonefrite , Salpingite , Ureter , Humanos , Feminino , Pessoa de Meia-Idade , Salpingite/diagnóstico , Tubas Uterinas , Doença Inflamatória Pélvica/complicações
13.
Fertil Steril ; 119(6): 1008-1015, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36774977

RESUMO

OBJECTIVE: To evaluate the outcome of pelvic inflammatory disease (PID) in patients with endometriosis with and without ovarian endometrioma. DESIGN: A retrospective cohort study. SETTING: A single university-affiliated tertiary center. PATIENT(S): A total of 116 patients with endometriosis hospitalized because of PID between the years 2011-2021. Fifty-nine patients with an ovarian endometrioma component were compared with 57 patients with endometriosis without endometrioma. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): The primary outcome was severe PID defined as the need for surgical intervention or drainage. Secondary outcomes included tubo-ovarian abscess, number of hospitalization days, a positive cervical bacterial culture or urine sexually trasmitted disease polymerase chain reaction (STD PCR) test, and readmission because of partially treated or relapsing PID. RESULT(S): PID in patients with endometrioma was found less likely to respond to antibiotic treatment with increased risk for surgical intervention or drainage compared with endometriosis patients without endometrioma (adjusted odds ratio, 3.5; confidence interval, 1.25-9.87). On admission, patients with endometrioma were older (26.5 vs. 31.0) and less likely to have an intrauterine device (19.3% vs. 5.1%) compared with patients without endometrioma. The rate of the tubo-ovarian abscess (52.5% vs. 19.3%) was significantly higher in patients with endometrioma. Readmission rate, positive bacterial culture, and hospitalization duration were higher in the endometrioma group; however, they did not reach statistical significance. Recent oocyte retrieval and patient's age were not associated with an increased risk of severe PID. CONCLUSION(S): Endometrioma patients with PID are less likely to respond to antibiotic treatment and present a higher risk for surgical intervention.


Assuntos
Endometriose , Doenças Ovarianas , Doença Inflamatória Pélvica , Feminino , Humanos , Endometriose/complicações , Endometriose/diagnóstico , Endometriose/tratamento farmacológico , Abscesso/diagnóstico , Abscesso/etiologia , Abscesso/cirurgia , Estudos Retrospectivos , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/diagnóstico , Doença Inflamatória Pélvica/tratamento farmacológico , Antibacterianos/efeitos adversos , Doenças Ovarianas/complicações , Doenças Ovarianas/diagnóstico , Doenças Ovarianas/tratamento farmacológico
14.
J Pediatr Adolesc Gynecol ; 36(3): 324-327, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36764511

RESUMO

INTRODUCTION: Although pelvic inflammatory disease is seen in sexually active women, it can also be seen in virgin girls. One of the conditions that can develop if not treated appropriately is pyosalpinx. A case of pyosalpinx causing xanthogranulomatous inflammation, a rare type of inflammation, is presented. CASE: A 15-year-old virgin adolescent patient underwent salpingectomy for left pyosalpinx, and the pathology result revealed xanthogranulomatous salpingitis. CONCLUSION: Pelvic inflammatory disease is extremely rare in virgin adolescents and there is usually an underlying anatomic anomaly. No anatomical anomaly was detected in our case, but the detection of E.coli in the abscess fluid culture and the chronic constipation of our patient made us think that the cause of the disease was an ascending infection originating from the gastrointestinal tract.


Assuntos
Doença Inflamatória Pélvica , Salpingite , Adolescente , Feminino , Humanos , Salpingite/complicações , Salpingite/diagnóstico , Salpingite/cirurgia , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/diagnóstico , Doença Inflamatória Pélvica/cirurgia , Salpingectomia/efeitos adversos , Abscesso
16.
Arch Gynecol Obstet ; 307(1): 139-148, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36036826

RESUMO

PURPOSE: To evaluate the clinical outcomes and prognosis of patients undergoing laparoscopic surgery for tubo-ovarian abscess (TOA) and identify risk factors for pelvic inflammatory disease (PID) recurrence. METHODS: We conducted a retrospective cohort analysis including 98 women who underwent laparoscopic surgery for TOA at the Department of Obstetrics and Gynecology at the Bern University Hospital from January 2011 to May 2021. The primary outcome studied was the recurrence of PID after TOA surgery. Clinical, laboratory, imaging, and surgical outcomes were examined as possible risk factors for PID recurrence. RESULTS: Out of the 98 patients included in the study, 21 (21.4%) presented at least one PID recurrence after surgery. In the univariate regression analysis, the presence of endometriosis, ovarian endometrioma, and the isolation of E. coli in the microbiology cultures correlated with PID recurrence. However, only endometriosis was identified as an independent risk factor in the multivariate analysis (OR (95% CI): 9.62 (1.931, 47.924), p < 0.01). With regard to the time of recurrence after surgery, two distinct recurrence clusters were observed. All patients with early recurrence (≤ 45 days after TOA surgery) were cured after 1 or 2 additional interventions, whereas 40% of the patients with late recurrence (> 45 days after TOA surgery) required 3 or more additional interventions until cured. CONCLUSION: Endometriosis is a significant risk factor for PID recurrence after TOA surgery. Optimized therapeutic strategies such as closer postsurgical follow-up as well as longer antibiotic and hormonal therapy should be assessed in further studies in this specific patient population.


Assuntos
Abscesso Abdominal , Endometriose , Doenças das Tubas Uterinas , Doenças Ovarianas , Doença Inflamatória Pélvica , Salpingite , Gravidez , Humanos , Feminino , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/cirurgia , Endometriose/complicações , Endometriose/cirurgia , Abscesso/cirurgia , Abscesso/complicações , Estudos Retrospectivos , Escherichia coli , Doenças das Tubas Uterinas/complicações , Doenças das Tubas Uterinas/cirurgia , Abscesso Abdominal/etiologia , Abscesso Abdominal/cirurgia , Salpingite/complicações , Salpingite/cirurgia , Fatores de Risco , Doenças Ovarianas/complicações , Doenças Ovarianas/cirurgia
17.
Ceska Gynekol ; 88(6): 472-479, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38171924

RESUMO

The aim of this article is to acquaint the gynaecological public with our experience with the use of computed tomography in the diagnosis of fluid collections in women with clinical suspicion of complicated pelvic inflammation or a complication after gynaecological surgery. We present diagnostic dilemmas that radiologists deal with, including differential diagnoses. We also deal with the benefits for the referring gynaecologist, and we also discuss the possible discrepancy between his expectations and the result of the examination.


Assuntos
Ginecologia , Doença Inflamatória Pélvica , Humanos , Feminino , Abscesso/diagnóstico , Tomografia Computadorizada por Raios X , Doença Inflamatória Pélvica/diagnóstico por imagem , Doença Inflamatória Pélvica/complicações , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos
18.
BMJ Case Rep ; 15(10)2022 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-36229077

RESUMO

A young woman in her 20s presented with fever, abdominal pain and malodourous vaginal discharge. She was found to be in septic shock, in the setting of a recent medical abortion with subsequent intrauterine device placement. Her blood cultures grew Fusobacterium necrophorum Despite appropriate antibiotic therapy, the fever failed to defervesce. Subsequent evaluation revealed septic thrombophlebitis of the right gonadal vein and branches of the right iliac vein. She improved with a prolonged course of targeted antimicrobial therapy.


Assuntos
Infecções por Fusobacterium , Doença Inflamatória Pélvica , Sepse , Infecções dos Tecidos Moles , Tromboflebite , Antibacterianos/uso terapêutico , Feminino , Febre/tratamento farmacológico , Infecções por Fusobacterium/complicações , Infecções por Fusobacterium/diagnóstico , Infecções por Fusobacterium/tratamento farmacológico , Fusobacterium necrophorum , Humanos , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/diagnóstico , Doença Inflamatória Pélvica/tratamento farmacológico , Sepse/complicações , Sepse/diagnóstico , Sepse/tratamento farmacológico , Infecções dos Tecidos Moles/tratamento farmacológico , Tromboflebite/complicações , Tromboflebite/diagnóstico , Tromboflebite/tratamento farmacológico
19.
BMC Womens Health ; 22(1): 348, 2022 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-35978309

RESUMO

BACKGROUND: This study aimed to determine the factors associated with an unfavorable clinical course (emergency surgery and/or prolonged hospitalization) in patients requiring hospitalization owing to pelvic inflammatory disease (PID). METHODS: A retrospective study was performed on 117 patients diagnosed with PID who were admitted to our hospital between January 2014 and December 2018. Multivariate regression analysis was conducted to determine the factors associated with emergency surgical intervention, and prolonged hospitalization in a subgroup of successful expectant management (n = 93). RESULTS: The average age (mean ± standard deviation) of the patients was 41.2 ± 12.5 years; 16 (13.7%) were postmenopausal; 81 patients (69.2%) complicated with a tubo-ovarian abscess (TOA) of which 59 (72.9%) had an ovarian endometrioma; and 19 patients (16.2%) had a history of various intrauterine manipulations. Emergency surgery was performed in 24 patients (20.5%), and patients with TOA underwent emergency surgery more often than did patients without TOA (25.9% vs. 8.3%, p = 0.03), and TOA was associated with longer length of hospital stay (17.1 days vs. 8.0 days, p = 0.01). Smoking, postmenopausal status, past medical history of PID, and high C-reactive protein (CRP) level at admission were significantly associated with emergency surgery. In patients with successful expectant management, obesity (body mass index ≥ 30) and high WBC and CRP level at admission were significantly associated with prolonged hospitalization. CONCLUSIONS: Of the patients requiring hospitalization owing to PID, TOA was associated with both emergency surgery and prolonged hospital stay. Patients with increased inflammatory markers and obesity should be considered to be at a high risk for unfavorable clinical course in the management of PID.


Assuntos
Doenças das Tubas Uterinas , Doenças Ovarianas , Doença Inflamatória Pélvica , Salpingite , Abscesso/complicações , Abscesso/terapia , Adulto , Doenças das Tubas Uterinas/complicações , Feminino , Humanos , Japão , Pessoa de Meia-Idade , Obesidade/complicações , Doenças Ovarianas/complicações , Doença Inflamatória Pélvica/complicações , Doença Inflamatória Pélvica/diagnóstico , Doença Inflamatória Pélvica/terapia , Estudos Retrospectivos
20.
Scanning ; 2022: 7531190, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35822160

RESUMO

In order to solve the complex and recurrent problem of chronic pelvic inflammation disease (CPID) in the process of the clinical treatment, a method of understanding the influencing factors of CPID by investigating the actual situation of clinical cases and using logistics regression analysis was proposed in this study. A total of 204 outpatients were selected from a certain hospital. The ratio of the cases in the experimental group to those in the control group stands at 1 : 1. The results were obtained as follows. According to the data of CPID patients collected in the paper, the majority of patients had a high school education background or below technical secondary school education background, accounting for 66.7%. And the majority of patients were manual workers, accounting for 69.1%. All the exp (B) values of the frequency of sex life per month ≥ 9 times, frequent sex life during menstruation, IUD contraception, no contraception, abortion ≥ 3 times, vaginal irrigation per week ≥ 1 time, and intrauterine surgery ≥ 3 times were more than 1. These seven factors were the risk factors for chronic pelvic inflammation. Oral contraceptives were a weak protective factor of chronic pelvic inflammation. These factors including early drug withdrawal (53.1%), without understanding the condition of the disease (35.7%), no time to review the disease (24.5%), and irregular medication (21.4%) accounted for a large proportion. They were associated with the recurrence of CPID. This method is aimed at providing some foundations for establishing effective prevention and control measures for chronic pelvic inflammation and providing a recognized clinical diagnosis and efficacy evaluation criteria for the treatment of chronic pelvic inflammation.


Assuntos
Infertilidade , Doença Inflamatória Pélvica , Feminino , Humanos , Infertilidade/complicações , Inflamação/complicações , Análise Multivariada , Doença Inflamatória Pélvica/complicações , Gravidez , Análise de Regressão
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