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Pelvic inflammatory disease - Management
When should I seek specialist advice or admit urgently?
- Admit urgently if:
- Ectopic pregnancy cannot be ruled out.
- Symptoms and signs are severe (such as nausea, vomiting, and a fever greater than 38°C).
- There are signs of pelvic peritonitis.
- A surgical emergency such as acute appendicitis cannot be ruled out.
- The woman is pregnant.
- A tubo-ovarian abscess is suspected.
- The woman is unwell and there is diagnostic doubt.
- The woman is unable to follow or tolerate an outpatient regimen.
- Consider seeking specialist advice:
- If the woman is immunocompromised (such as HIV, taking immunosuppressants).
- Admission is required for women who have HIV only if they have clinically severe pelvic inflammatory disease (PID).
- Discussion with a genito-urinary specialist or gynaecologist is advised if there is doubt regarding whether admission is necessary.
- If peri-hepatitis (Fitz–Hugh–Curtis syndrome) is suspected.
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