Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0242172 (pelvic inflammatory disease)
 3,755 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An assessment of gynecological morbidity among 385 married mothers of children 6-12 months of age from a district in South India's Karnataka State revealed a high burden of reproductive tract infections. Research methods included clinical examination, laboratory tests, and self-reports. A total of 152 women reported 226 gynecological complaints to a social worker, primarily vaginal discharge with bad odor and itching or irritation (22%), lower abdominal pain or vaginal discharge with fever (16%), and menstrual bleeding disorders or pain (15%). Under more extensive probing by a gynecologist, the proportion of women reporting menstrual problems rose to 62%. At medical examination, 36% of women had at least one clinically diagnosed reproductive tract infection, including pelvic inflammatory disease (11%), cervical ectopy (10%), and genital prolapse (3%). More than half had endogenous infections. The two most common infections, identified by laboratory tests, were bacterial vaginosis (18%) and mucopurulent cervicitis (37%). Sexually transmitted diseases, primarily trichomonal vaginalis, were diagnosed in 10%. Women residing in town, those with 6 or more years of schooling, and women with 4 or more pregnancies were significantly more likely to report menstrual problems. Laboratory-detected vaginosis was significantly higher among urban and sterilized women. There were no significant associations between demographic/socioeconomic status variables and the other reproductive health problems analyzed. Finally, severe anemia was present in 17% and chronic energy deficiency in 12%. The combination of widespread undernutrition/malnutrition and reproductive tract infections revealed in this study indicates an urgent need to take steps to implement the reproductive health strategy outlined at the 1994 Cairo Conference in South India.
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PMID:Levels and determinants of gynecological morbidity in a district of south India. 921 30

Since 1937, 13 Mycoplasma species, two Acholeplasma species, and one Ureaplasma species have been isolated from humans. Six of these have the urogenital tract as the primary site of colonisation but others, which have the oropharynx and respiratory tract as the primary site, are found occasionally in the urogenital tract because of orogenital contact. Mycoplasma hominis was the first to be isolated and is most strongly associated with bacterial vaginosis (BV), together with a variety of other bacteria. Its involvement in pelvic inflammatory disease (PID) and other conditions may be as part of BV, although when isolated in pure culture from the blood of women who have postpartum or postabortal fever there is no reason to suspect its aetiological role. There is evidence for an aetiological role for Ureaplasma urealyticum organisms (ureaplasmas) in acute non-gonococcal urethritis (NGU) and particularly chronic NGU in men, but they rank third to Chlamydia trachomatis and M. genitalium. Whether the association of ureaplasmas with miscarriage and preterm labour is in the context of BV is not clear. Of no doubt, however, is the ability of ureaplasmas to cause septic arthritis in hypogammaglobulinaemic patients and there is evidence that they may cause some cases of sexually acquired reactive arthritis. The advent of polymerase chain reaction technology has seen an advance in the understanding of the role of M. genitalium; there is strong evidence that it is one of the causes of both acute and chronic NGU independent of C. trachomatis. There is some support for the role of M. genitalium in PID, but this needs to be substantiated. Other mycoplasmas, for example M. fermentans, M. pivum, M. primatum, M. penetrans, M. spermatophilum and even M. pneumoniae have the capacity to cause urogenital tract disease but there is no evidence to indicate that they do so.
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PMID:Genital mycoplasma infections. 928 63

Mycoplasma hominis and Ureaplasma urealyticum can be isolated with considerable frequency from the human urogenital tract and are thought to cause various syndromes such as nongonococcal urethritis, pelvic inflammatory disease, pyelonephritis or infertility. The aim of this study was the evaluation of the presence of different genital pathogens in patients with sexually transmitted diseases (STD) and, in particular, the detection of mycoplasmas in individuals infected with genital microbes and an assessment of the presence of genital microorganisms in patients harbouring Mycoplasma hominis or Ureaplasma urealyticum. Furthermore, the occurrence of mycoplasmas in women with bacterial vaginosis was established. Specimens were collected from a total of 41,980 persons attending the Outpatients' Centre for Infectious Venero-Dermatological Diseases in Vienna from 1994 to 1996. Of all genital pathogens, Ureaplasma urealyticum was cultured most frequently in men and women. Mycoplasma hominis and Ureaplasma urealyticum were detected more often in the vaginal fluid than in the male urethra. By contrast, infection rates with Neisseria gonorrhoeae and Chlamydia trachomatis were higher in men than in women. In both men and women, trichomoniasis increased colonisation with Mycoplasma hominis, while mycoplasmas occurred less frequently together with genital candidiasis. Mycoplasma hominis was cultivated significantly more often in women with bacterial vaginosis than in those without. In contrast to urethral infections in men, cervical infections with Neisseria gonorrhoeae or Chlamydia trachomatis raised the incidence of Mycoplasma hominis in the vaginal fluid.
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PMID:Mycoplasma hominis and Ureaplasma urealyticum in patients with sexually transmitted diseases. 928 64

Reported rates of post-abortion pelvic inflammatory disease (PID) range from 5-29%. The risk of infection has been associated with the presence of Neisseria gonorrhoeae, Chlamydia trachomatis, and anaerobic organisms in the lower genital tract. The present study analyzed the prevalence of genital tract infections in 1672 women undergoing induced abortion at 3 centers in Scotland and evaluated the efficacy of two preventive interventions. Prevalence rates of lower genital tract gonorrhea, chlamydia, and bacterial vaginosis before abortion were similar to those identified in other UK studies. Women were randomly allocated to receive either prophylactic metronidazole (immediately before abortion) and doxycycline (for 7 days after abortion) or received antibiotics only if pre-abortion genital tract swabs were positive for any of the 3 infections. During the 8-week post-abortion follow-up period, women managed by the screen-and-treat protocol had slightly less favorable outcomes in terms of hospital readmissions, general practitioner consultations, antibiotic prescriptions, time off work, and limitations on domestic activities than women who received prophylactic treatment. Differences were statistically significant, however, only for women whose swabs were negative for all 3 infections. The rate of post-abortion PID/endometritis in this groups was 3% among women who received prophylactic antibiotics and 6% in those who were screened and not treated. These findings suggest that universal antibiotic prophylaxis may represent the most cost-effective approach to minimizing the risk of infective morbidity. Advocated for consideration is a third strategy involving prophylaxis at the time of abortion followed by screening for gonorrhea and chlamydia to ensure adequate follow-up of treatment results and partner notification.
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PMID:Preventing infective sequelae of abortion. 943 66

Bacterial vaginosis is the most common cause of vaginal discharge. Recent studies have confirmed its association with pelvic inflammatory disease and adverse pregnancy outcomes. Bacterial vaginosis is treated with oral metronidazole (given either as a single dose or a seven-day course) or clindamycin. Treatment with topical clindamycin or metronidazole is also effective in returning the vaginal flora to normal but may be less effective in preventing the increased incidence of adverse pregnancy outcomes.
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PMID:Bacterial vaginosis: an update. 953 4

The presence of infection in the lower genital tract at the time of induced abortion has been associated with an increased risk of postabortion pelvic inflammatory disease (PID). The present study investigated the prevalences of Neisseria gonorrhoeae, Chlamydia trachomatis, and bacterial vaginosis among 1672 women undergoing induced abortion at four Scottish hospitals in 1995-96. It further compared the effectiveness of two clinical management strategies for minimizing the risk of postabortion infection. Women were randomly assigned to receive either 1 g of metronidazole rectally before abortion and 100 mg/day of doxycycline for 7 days (n = 826) or treatment only if screening was positive for infection (n = 846). Preabortion lower genital tract screening indicated 3 women (0.2%) were positive for N. gonorrhoeae, 91 (5.6%) for C. trachomatis, and 282 (17.5%) for bacterial vaginosis. A review of the rates of general practitioner consultations, antibiotic prescriptions, and hospital readmissions in the 8 weeks postabortion showed that symptoms were minor and similar in duration and intensity among women in both treatment groups. The postabortion PID/endometriosis rate was 4.6% among women in the prophylaxis group and 6.8% in the screen-and-treat group. Women in these two groups who were initially positive for 1 or more infection had significantly higher rates of postabortion PID/endometriosis (7.7% and 7.4%, respectively) than those who were initially negative (3.1% and 5.7%, respectively). Antibiotics had to be prescribed postabortion to 13.1% of women initially positive for 1 or more infection compared with 7.8% of those initially negative. The cost of universal prophylaxis (8.17 pounds) was less than half that of screening with treatment and follow up of positive cases.
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PMID:A randomised comparison of strategies for reducing infective complications of induced abortion. 1042 55

Bacterial vaginosis being the most frequent vaginal infection is the leading cause of genital fluor. The author reviews the latest developments regarding the etiology, diagnostics and therapy of disease. Per os metronidazol and intravaginal clindamycin play the main role in treatment. The most often occurring complications of bacterial vaginosis are premature rupture of membrane and premature labour, postpartum endometritis, pelvic inflammatory disease and gynecological postoperative infections.
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PMID:[Bacterial vaginosis]. 965 70

Pelvic inflammatory disease (PID) is the must important gynecologic infectious disease. It causes not only serious clinical symptoms, life threatening complications, but also severe damage to the female upper reproductive tract. Among its important sequale are infertility due to tubal occlusion, ectopic pregnancy, dyspareunia, and chronic pelvic pain. The must important causative organisms are Neisseria gonorrhoeae, Chlamydia trachomatis, as well as anaerobic and facultative bacteria found in the vaginal flora of women with bacterial vaginosis. The author reviews the latest developments regarding the epidemiology, etiology diagnostics, medical and surgical therapy of the disease. The importance and possibilities of prevention are discussed.
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PMID:[Inflammation of the pelvis minor]. 975 75

Pelvic inflammatory disease (PID) refers to infection of the uterus, fallopian tubes, and adjacent pelvic structures that is not associated with surgery or pregnancy. PID causes major medical, social, and economic problems worldwide. Long-term sequelae, most notably tubal factor infertility and ectopic pregnancy, are common and extremely costly to the healthcare system. The most important causative micro-organisms are Chlamydia trachomatis, Neisseria gonorrhoeae, and micro-organisms associated with bacterial vaginosis. The clinical spectrum of PID ranges from subclinical endometritis to severe salpingitis, pyosalpinx, tubo-ovarian abscess, pelvic peritonitis, and perihepatitis. Clinical diagnosis of PID has limitations. The clinical diagnostic criteria are insensitive and nonspecific, and false-positive and false-negative diagnosis is common; however, direct visual diagnosis is not always feasible, requires general anesthesia, and is costly. More research is needed of noninvasive diagnosis of PID. Current treatment guidelines call for broad-spectrum antimicrobial coverage. Screening for asymptomatic chlamydial infection is the mainstay of prevention of PID. Emerging evidence from randomized controlled trials provides strong evidence that intervention with selective screening for chlamydial infection effectively reduces the incidence of PID.
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PMID:Pelvic inflammatory disease. From diagnosis to prevention. 989 75

In men urethral discharge is commonly caused by Neisseria gonorrhoeae and Chlamydia trachomatis. Both organisms cause an acute anterior urethritis and infected men usually present with symptoms of urethritis. A proportion of men with urethral infection may remain asymptomatic. Amongst women the common cause of vaginal discharge is vaginitis caused by Trichomonas vaginalis, Candida albicans and anaerobic bacterial infection (bacterial vaginosis). However, cervicitis caused by N. gonorrhoeae and C. trachomatis also causes vaginal discharge. Cervicitis is the more serious cause of vaginal discharge as the aetiologic agents may lead to infection ascending above the internal os of the cervix resulting in pelvic inflammatory disease and other complications.
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PMID:Syndromic management of sexually transmitted diseases. Part 2--The management of genital discharge. 1010 31


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