Pelvic inflammatory disease: clinical overview.

Acute pelvic inflammatory disease (PID) adversely affects the health of 1 million American women annually. The best understood etiologic organisms are Chlamydia trachomatis and Neisseria gonorrhea; however, information regarding the contributions of facultative and causative anaerobes continues to emerge. Chronic PID presents a diagnostic and management challenge to health care providers. Because of morbidity and sequelae the importance of early detection of, and intervention for, upper tract pelvic infections cannot be overemphasized. Nursing interventions in PID prevention, early assessment, accurate diagnosis, and thorough treatment can have a positive impact on women's health.

Pelvic inflammatory disease.

A dramatic increase in the incidence of pelvic inflammatory disease in recent years has led to a parallel increase in consequent infertility. The economic and psychologic costs of infection and infertility are severe and preventable. The author reviews and outlines current diagnostic and therapeutic recommendations that are now being used to prevent infectious morbidity. A brief review of the indications, techniques, and prospects for surgical correction of tubal disease and pelvic adhesions is also presented.

Gynecologic care for women with HIV infection.

The purpose of this article is to review the gynecologic conditions encountered among women with HIV and to outline elements of gynecologic care for these women. The most prevalent problems are vulvo-vaginal candidiasis and cervical dysplasia; however, other sexually transmitted diseases, pelvic inflammatory disease, genital ulcer disease, and menstrual abnormalities are also seen. Drug interactions may limit the effectiveness or increase the toxicities associated with hormonal contraception. Intrauterine devices are contraindicated.

The CDC 2002 guidelines for the treatment of sexually transmitted diseases: implications for women's health care.

Persons rely on health care providers to make diagnostic and therapeutic decisions based on the most current information. With areas of practice changing rapidly, providers are challenged to keep abreast of new and changing treatment guidelines. The new Centers for Disease Control and Prevention (CDC) 2002 Sexually Transmitted Disease (STD) Treatment Guidelines provide clinical guidance in the appropriate assessment and management of STDs. This article reviews recent changes in the STD Treatment Guidelines for the most common disease entities and their sequelae encountered by women's health practitioners. The changes noted in this article include new screening recommendations, use of new diagnostics, new treatment algorithms, and changes in therapeutic regimens.

Pelvic inflammatory disease and sepsis.

Pelvic inflammatory disease affects approximately 1 million women per year in the United States alone and has a variety of causative organisms. Because the diagnosis of PID is based on clinical judgment, health care providers need to be guided by the CDC recommendations for diagnosing and treating PID. Because presenting symptoms are often vague, the health care provider should assess female patients for risky behaviors that may lead to PID and should use screening data when making clinical judgments and differential diagnoses. Whenever possible, female patients with PID should be treated as outpatients. If diagnosis and treatment are not performed in a timely manner, PID may cause sepsis, septic shock, and even death. Even if they survive, as many as 15% to 20% of these women experience long-term sequelae of PID, such as ectopic pregnancy, tubo-ovarian abscess, infertility, dyspareunia, and chronic pelvic pain. The best treatments for PID are interventions that lead to prevention and early detection. The critical care nurse has an important role in recognizing the variables that may lead to PID-related sepsis and in encouraging health-seeking and health-maintenance behaviors among women with these diagnoses.

Teaching and communication strategies: working with the hospitalized adolescent with pelvic inflammatory disease.

The increased incidence of sexually transmitted disease (STD) in the adolescent population has led the Centers for Disease Control and Prevention to highly recommend inpatient therapy for all adolescents with pelvic inflammatory disease (PID). This in turn has led to an increased need for nurses in inpatient settings to be skilled at providing sexuality education to adolescents with PID. The nurse needs a clear understanding of STD and PID, and the ability to communicate effectively with adolescents to help them make healthy decisions about their sexual behavior.

Pelvic inflammatory disease: a review of therapy.

Pelvic inflammatory disease (PID) is a serious health problem that affects the reproductive capacity and the sexual activities of women. Approximately 50,000 cases are reported annually resulting in severe pain, reduced fertility and costly health care. Diagnosis of PID requires a complex analysis of the history, a thorough physical examination and diagnostic testing. Goals of care include accurate diagnosis with particular emphasis on differential diagnosis, antibiotic therapy, close follow-up and counseling. Antibiotic therapy is directed against the pathogenic organism, either gonococcal or nongonococcal. Careful counseling and follow-up aids successful treatment and decreases the likelihood of infertility.