How to check for pelvic inflammatory disease

  Pelvic inflammatory disease (PID), a group of infectious diseases of the upper female genital tract, mainly includes endometritis, tubal inflammation, tubo-ovarian abscess, and pelvic peritonitis. Inflammation may be confined to one site or may involve several sites at the same time, with tubal inflammation and tubo-ovarian inflammation being the most common.  Tests for pelvic inflammatory disease include gynecological examination (double or triple diagnosis), vaginal smear for leukocytes, culture and nucleic acid amplification for pathogens, ESR and CRP, vaginal ultrasound or pelvic magnetic resonance imaging (MRI), laparoscopy, etc. Since the clinical manifestations of pelvic inflammatory diseases vary widely and the above-mentioned tests are not yet both sensitive and specific, it is difficult to make a correct clinical diagnosis, but the delay in diagnosis leads to the occurrence of sequelae (chronic pelvic inflammatory disease). The diagnostic criteria for pelvic inflammatory disease recommended by the Centers for Disease Control in the United States in 2010 are now mostly used in medicine.  Minimum criteria: painful cervical lift or uterine pressure or pressure in the adnexal area Additional criteria: temperature over 38.3°C (oral surface); abnormal mucopurulent discharge from the cervix or vagina; large number of leukocytes on wet film of vaginal discharge; elevated erythrocyte sedimentation rate; elevated blood C-reactive protein; laboratory-confirmed positive cervical Neisseria gonorrhoeae or Chlamydia Specific criteria: histologically confirmed endometritis on endometrial biopsy Vaginal ultrasound or magnetic resonance examination showing thickened fallopian tubes, tubal effusion with or without pelvic fluid, tubo-ovarian mass, or laparoscopic findings of signs of pelvic inflammatory disease (marked congestion on the surface of the fallopian tubes, wall edema, and purulent exudate on the umbilical or plasma surface) Clinically, excluding lower abdominal pain caused by other factors and meeting the above minimum diagnostic criteria, the patient should be considered to have pelvic inflammatory disease and given broad-spectrum antibiotic treatment, and timely and effective treatment within 48 hours can significantly reduce the occurrence of sequelae.