Pelvic Inflammatory Disease: Criteria for Diagnosis

The clinical criteria for diagnosing Reference pelvic inflammatory disease (PID) Opens New Window are as follows.^{Reference 1}

Minimum criteria

Any of these three criteria diagnose PID if no other cause can be found.

• Lower abdominal tenderness or pain
• Pain or tenderness when the ovaries or fallopian tubes are touched or moved during examination
• Pain or tenderness when the cervix is touched or moved during examination

Criteria that increase the likelihood of PID

The presence of any of the following symptoms increases the likelihood that you have PID:

• Green or yellow vaginal discharge
• A laboratory test result confirming Reference gonorrhea Opens New Window or Reference chlamydia Opens New Window
• Oral temperature of 101°F (38.3°C) or higher
• Many white blood cells in vaginal or cervical discharge
• Higher-than-normal erythrocyte sedimentation rate (ESR) or C-reactive protein. These are signs of possible infection.

Additional criteria for diagnosis of PID

Other clinical criteria used to diagnose PID include the following:

• Cells removed from the uterus by endometrial biopsy indicate infection and inflammation (Reference endometritis Opens New Window).
• A Reference tubo-ovarian abscess Opens New Window is visible on ultrasound.
• An exam of the abdomen or pelvis by Reference laparoscopy Opens New Window finds inflammation or abscesses of the fallopian tubes, ovaries, or other pelvic structures. Laparoscopy and ultrasound are considered the best procedures for diagnosing PID. But these procedures are not done unless the diagnosis is in doubt or the results from the procedure will change the method used in treatment.

Many health professionals think that even if a woman has no pelvic symptoms, she should be treated for PID if she has pain or tenderness when the cervix is moved and has signs of Reference cervicitis Opens New Window (inflammation of the cervix).

The treatment for PID is longer and may use different medications than the treatment for a vaginal or cervical infection.

If symptoms come back after treatment, other possible causes for the symptoms are considered each time. It sometimes takes more than one course of medicine treatment to cure PID. It is also possible that a reinfection has occurred or that the original diagnosis may not have been correct. Your sex partner(s) must be treated at the same time you are.

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