Pelvic inflammatory disease due to Pseudomonas fluorescens in patient wearing an intrauterine device.
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Adult↗
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Results for “Reproductive Tract Infections--etiology”
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Polymicrobial etiology of acute pelvic inflammatory disease.
We studied 204 women with acute pelvic inflammatory disease to delineate further the causes of that illness. Gonococci were recovered from 91. Gonococcal pili antibody rose or fell significantly in 12 of 18 patients with positive cultures and only two of 19 who had negative cultures and smears for Neisseria gonorrhaoea(P smaller than 0.005). N. gonorrhoeae was found in peritoneal exudate from eight of 21 patients with, and none of 33 without, cervical gonococcal infection. Among patients with severe disease, other bacteria were recovered from peritoneal exudates from five of 16 with, and 19 of 22 without, cervical gonococcal infection (P smaller than 0.025). Mixed anaerobic and aerobic bacterial peritoneal infection was common in nongonococcal pelvic disease. The most common species recovered were Bacteroides fragilis, peptostreptococci, and peptococci. Tuboperitoneal gonococcal infection probably causes pelvic inflammatory disease in most patients with cervical gonococcal infection, whereas polymicrobial tuboperitoneal infection probably causes most nongonococcal cases.
Acute Disease↗
On the causation of pelvic inflammatory disease.
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Animals↗
Alternative causes of pelvic inflammatory disease.
Seminal fluid from asymptomatic men reveals a wide variety of aerobic and anaerobic bacteria. The number of bacteria tends to correlate with the sexual experience of the individual. Experimental evidence has shown that these bacteria can attach themselves to moving spermatozoa and travel through ovulatory-phase cervical mucus. Exogenously added bacteria also exhibit the same potential. These experimental results suggest a rational explanation for the development of pelvic inflammatory disease in promiscuous women with multiple sexual partners. In addition, the findings help to explain the marked difference observed in the rate of pelvic inflammatory disease among patients using barrier-type birth control and oral contraceptives as compared with the rate among women who use intrauterine devices, with which the ovulatory-phase cervical mucus is unprotected.
Adolescent↗
Clinical aspects of acute pelvic inflammatory disease: Cook County Hospital.
We reviewed Cook County Hospital records of 134 consecutive patients hospitalized for acute pelvic inflammatory disease unrelated to intrauterine devices, delivery, or pelvic surgery. Nearly half our patients had peritonitis or a pelvic mass and most were young or nulliparous. Neisseria gonorrhoeae was recovered from the endocervices of 41 (34%) of 120 patients and was more common among younger patients. Most patients responded to antibiotic therapy; consequently, we recommend antibiotic treatment for acute PID unless surgical emergencies cannot be excluded or patients do not improve with antibiotic therapy alone.
Adult↗
Infectious morbidity due to Bacteroides fragilis in obstetric patients.
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Abortion, Septic↗
[Tubal actinomycosis as a complication of intrauterine contraception].
A case of actinomycosis of the uterine tube occuring in a 29-year-old clerk is reported. The disease became manifest clinically a month after the introduction of IUD. In spite of intensive antiinflammatory therapy the disease was in progress and cachexia developed. The case was cured only after radical surgical intervention and antibiotic treatment.
Actinomycosis↗
Chlamydia trachomatis infection in patients with laparoscopically verified acute salpingitis. Results of isolation and antibody determinations.
Culture and serology studies have shown Chlamydia trachomatis (CT) to be one of the causes of acute salpingitis (AS). In the present investigation, results of cervical cultures were correlated with serum antibody titers to CT in patients with laparoscopically verified AS. Serum samples from 206 patients, including paired sera from 80, were assayed. Of 206 patients, 118 had chlamydial IgG antibody titers of 1:64 or more. Patients with negative cultures for CT and an IgG titer of 1:64 or more had a significantly higher geometric mean titer than corresponding patients with positive cultures. In paired sera, a seroconversion or a fourfold or greater rise in IgG titer to CT was demonstrated in 35%, while a further 11% had detectable IgM antibody in a titer of 1:8 or more. The overall isolation frequency of CT was 33%, compared with 19% for Neisseria gonorrhoeae.
Adolescent↗
Pelvic inflammatory disease: guidelines for prevention and management.
This report provides comprehensive guidelines to aid practitioners and decision makers in achieving PID prevention and management objectives. The main focus of this document is PID related to STD. These guidelines for the prevention and management of PID were established by staff of CDC in consultation with a group of outside experts. Current data regarding the efficacy of prevention strategies and management approaches form the basis for the guidelines. Because data are incomplete, however, certain aspects of these guidelines represent the current consensus judgment of the consulted experts. Recommendations in this document should be considered a source of guidance to health practitioners.
Anti-Bacterial Agents↗
Pelvic inflammatory disease and its sequelae in adolescents.
Pelvic Inflammatory Disease (PID) is the most common serious complication of sexually transmitted diseases (STDs). Each year over one million women in the United States experience an episode of PID, with approximately 16-20% of cases occurring in teenagers. Acute PID increases a woman's risk for recurrent PID, chronic pelvic pain, infertility, and ectopic pregnancy. Recent reports indicating that PID rates are rising and are highest among adolescent females aged 15-19 underscore the need to remain current on the clinical as well as the epidemiologic aspects of PID. We present such an update in this article. Trends in incidence and key risk factors are discussed; besides adolescence itself and STD, other important categories of risk factors include sexual activity, contraceptive method, and previous episode(s) of PID. The polymicrobial nature of PID is discussed along with an analysis of the role of specific organisms, such as Chlamydia trachomatis, Neisseria gonorrhoeae, anaerobic and aerobic bacteria, and mycoplasmas in PID. Early diagnosis and the institution of appropriate treatment regimens are essential to the prevention of PID's devastating sequelae. Clinicians must maintain a high index of suspicion for the wide range of clinical presentations associated with PID and be prepared to provide effective management, including proper evaluation and prompt treatment of sexual partners.
Adolescent↗
Acute pelvic inflammatory disease.
Acute pelvic inflammatory disease is one of the most important consequences of sexually transmitted infection. Of sexually active women in the United States, one million (or 1 per cent) develop the infection. The sequelae include infertility (10 per cent), ectopic pregnancy (5 per cent), chronic pain (15 per cent), and recurrent infection (25 per cent). Organisms that cause the infection include Neisseria gonorrhoeae, Chlamydia trachomatis, genital mycoplasma, and a wide variety of facultative and anaerobic bacteria. Prompt recognition and therapy are necessary to reduce the sequelae.
Acute Disease↗
Dysuria in infancy and childhood: an analysis of 42 children presenting in the paediatrics outpatients department.
Urinary tract infection (UTI) was the only pathology found among 42 children presenting at the paediatric outpatient department with pain or straining on micturition. 18 (42.9%) had cystourethritis proven bacteriologically. 3 of these had gonococcal urethritis and were all males aged less than 3 years. Four had vasical schistosomiasis. No definite diagnosis could be made in 24 (57.1%) cases. Only secondary symptoms of gross haematuria, urethral discharge and cloudy urine were of diagnostic value, others were not. Children without these specific secondary symptoms predominate and may or may not have urinary tract pathology. Urinary leucocyte count on native urine is a useful screening test to identify those to be further investigated.
Child↗
Incidence, prevalence, and trends of acute pelvic inflammatory disease and its consequences in industrialized countries.
Pelvic inflammatory disease is used herein synonymously with acute salpingitis. In modern industrialized countries, the annual incidence of PID in women 15 to 39 years of age seems to be 10 to 13 per 1,000 women, with a peak incidence of about 20 per 1,000 women in the age group 20 to 24 years. Since 1960 an increase in incidence by a factor of 1.6 to 1.9 has been observed in the age group 20 to 29 years. The incidence of PID is correlated strongly with the prevalence of sexually transmitted diseases, although a fraction of the infections might be of endogenous origin. Use of intrauterine contraceptive devices and operations for legal abortions contribute to the increase in incidence. The prevalence of women in the post-PID state has increased by a factor of about 1.5 since 1960. Women in the post-PID state have a tenfold increased risk for ectopic pregnancy and 25% of the increase in ectopic pregnancy can be accounted for by the increase in post-PID women. Infertility after PID ranges between 5.8% and 60% depending on severity of infection, number of infections, and age of the women. The fraction of women rendered infertile because of PID has increased by a factor of about 1.6 since 1960.
Adolescent↗
Genital and neonatal chlamydial infection in a trachoma endemic area.
85 consecutive male patients with urethritis attending the Medical Research Council outpatient department in Fajara, The Gambia, were investigated for Chlamydia trachomatis infection by intraurethral swab and culture on cycloheximide-treated McCoy cells. 7 specimens were contaminated, but C. trachomatis was isolated from 12 of the remaining 78 (15.4%)--from 8 of 59 patients with gonorrhoea (13.6%) and 4 of 19 with non-gonococcal urethritis (21%). C. trachomatis was also isolated from cervical swabs from 6 of 33 female contacts of men with urethritis (18.2%), 3 of 22 women with gynaecological symptoms (13.6%), and 6 of 87 randomly selected antenatal women (6.9%). Eye swabs were taken from 37 infants with ophthalmia neonatorum; C. trachomatis was isolated from 13 (35.1%).
Adult↗
Antibodies to Chlamydia trachomatis in acute salpingitis.
Recent isolation studies have shown Chlamydia trachomatis to be an important aetiological agent in acute salpingitis in women. The present serological study indicates that C. trachomatis is the probable aetiological agent in two-thirds of 143 women with pelvic inflammatory disease (PID). In general, high levels of chlamydial antibody were found in sera and fluids aspirated from the pouch of Douglas and such antibody titres were shown to correlate with the severity of clinically graded tubal inflammation.
Acute Disease↗
Several factors influencing the colonization of group B streptococci--rectum probably the main reservoir.
Women (1 268) attending a gynaecological clinic or a venereal disease clinic had positive cultures of group B streptococci from urethra in 27.8% and from rectum in 29.4%. The colonization rate was highest in patients from the venereal disease clinic (p less than 0.001). In a study of 405 of the females at different parts of the menstrual cycle group B streptococci were detected during the last half of the cycle in specimens from cervix in 18%, from urethra in 29% (p less than 0.005), and from rectum in 35% (p less than 0.001). The correlation between contraceptive methods and isolation of group B streptococci was investigated for 435 women. Females with intrauterine devices but not those using oral contraceptives had a significantly increased colonization rate genitally. The colonization rate of group B streptococci was also studied in 271 women using sanitary tampons and 129 women using sanitary towel. Those using tampons were significantly more often colonized. Cultures for Neisseria gonorrhoeae were performed from 380 patients but no correlation between N. gonorrhoeae and group B streptococci was found. The study supports the view that rectum and not the genito-urinary tract is the main reservoir of group B streptococci in females, that genital colonization mainly represents contamination from the gastrointestinal flora and sexual transmission is only one of many factors influencing the colonization rate.
Adult↗
Migrant labor and sexually transmitted disease: AIDS in Africa.
Acquired immune deficiency syndrome (AIDS) is worldwide, but the clinical and epidemiological pattern of the disease in Africa is different from that in developed areas. "Type 1 AIDS" occurs in industrialized North America and Europe; it has a distinctive sex ratio (16:1) and risk pattern of IV drug use and sexual practices. "Type 2 AIDS" occurs in Third World countries, particularly in eastern, southern, and central Africa. It is characterized by an entirely different sex ratio (1:1) and by distinctively different risk patterns. Both epidemics are caused by the HIV-1 virus. The key concept for understanding the origins of the differences between Type 1 and Type 2 AIDS is the migratory labor system in eastern, central, and southern Africa. This system causes long absences, increased family breakdown, and increased numbers of sexual partners. Historically the organization of this labor market has created a population which suffers from epidemics of sexually transmitted diseases. These historical patterns are presented as evidence for the contemporary transmission of AIDS. When contemporary AIDS and HIV-1 seropositivity prevalence data are examined, a systematic temporal and geographic pattern emerges for the AIDS epidemic in Africa. Despite a paucity of good data, the prevalence data from eastern, central, and southern Africa support the thesis of migrant labor's role in the transmission of AIDS.
Acquired Immunodeficiency Syndrome↗