Acute Pelvic Inflammatory Disease in Outpatients: Association with Chlamydia trachomatis and Neisseria gonorrhoeae

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Abstract
Among 830 women attending a clinic for sexually transmitted diseases, C. trachomatis was isolated from 180 (22%) and N. gonorrhoeae from 84 (10%). Retrospective analysis showed that 43 of the women were given outpatient treatment for acute pelvic inflammatory disease because they had low abdominal pain, deep dyspareunia or unusual vaginal bleeding, or all of these, for < 2 mo. in association with cervical motion or adnexal tenderness, or both. None had adnexal masses. C. trachomatis was isolated from 22 and N. gonorrhoeae from 15 of this subgroup of 43 women. This presentation of pelvic inflammatory disease occurred in 10 of the 37 women in the whole study with both C. trachomatis and N. gonorrhoeae, 12 of 143 women with C. trachomatis alone, 5 of 47 women with N. gonorrhoeae alone and 16 of 603 women with neither organism. Thus, in North America, C. trachomatis is evidently associated with a syndrome usually diagnosed as mild pelvic inflammatory disease and managed on an outpatient basis.

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