Sexually Transmitted Diseases (STDs) Slideshow Pictures

Medical Author:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Exams and Tests

A health care practitioner usually will diagnose PID by taking the individual's medical history, doing a physical exam, and ordering appropriate tests.

Physical exam findings in PID often include the following:

• a temperature greater than 101 F (38.3 C);
  
  
• abnormal vaginal discharge;
  
  
• lower abdominal tenderness when exterior pressure is applied;
  
  
• tenderness when the cervix is moved (during a bimanual or speculum exam); or
  
  
• tenderness in female organs (ovaries).

Laboratory tests may include the following:

• a urine or serum pregnancy test if the female is of childbearing age;
  
  
• urinalysis to check for bladder and kidney infection;
  
  
• a complete blood count (although fewer than half of women with acute PID have a high white blood cell count indicating an infection);
  
  
• cervical cultures for gonorrhea and chlamydia;
  
  
• tests for other sexually transmitted diseases, including syphilis and HIV; and
  
  
• additional tests (see below) if more severe symptoms are present.

Imaging

A pelvic ultrasound, although not routinely done, can be an important tool in diagnosing complications such as tubo-ovarian abscesses, ovarian torsion, ovarian cysts, and ectopic pregnancy. Although unlikely to occur in pregnancy, PID is the most commonly missed diagnosis in ectopic pregnancies and can occur during the first 12 weeks of pregnancy.

Exploratory Surgery

A woman's health specialist (a gynecologist) can use a laparoscope (a small tube with a camera attached) and make small surgical incisions in and around the navel to view the reproductive organs and evaluate whether inflammation is present. The doctor can also identify an ectopic pregnancy using this technique. Definitive care can then be provided from starting IV antibiotics to removing an ectopic pregnancy.