![[ Visit Client Website ]](images/banner.gif)
Background: Pelvic inflammatory disease (PID) disproportionately affects adolescent girls, who frequently present to the emergency department (ED) with sexual health complaints. Recognition and treatment of PID is essential to prevent significant sequelae, including infertility, ectopic pregnancy, and chronic pelvic pain.
Objectives: To describe the prevalence and microbial patterns of PID in a cohort of adolescent patients presenting to an ED with lower abdominal or genitourinary complaints.
Methods: This is a secondary analysis of a prospective study of females ages 14-19 years presenting to a pediatric ED with lower abdominal or genitourinary complaints. Diagnosis of PID was per 2006 CDC guidelines. Patients underwent Chlamydia Trachomatis (CT) and Neisseria Gonorrhea (GC) testing via urine APTIMA Combo 2 Assay and Trichomonas vaginalis (TV) testing using the vaginal OSOM Trichomonas rapid test. Descriptive statistics were performed using STATA 11.0.
Results: The prevalence of PID in this cohort of 328 patients was 19.5% (95% CI 15.2%, 23.8%); 37.5% (95% CI 25.3%, 49.7%) of which had positive sexually transmitted infection (STI) testing: 25% (95% CI 14.1%, 35.9%) with CT, 7.8% (95% CI 1.1, 14.6% ) with GC; 12.5% (95% CI 4.2%, 20.8% ) with TV. 84.4% (95% CI 75.2, 93.5%) of patients diagnosed with PID received antibiotics consistent with CDC recommendations. Patients with lower abdominal pain as their chief complaint were more likely to have PID than patients with genitourinary complaints (OR 3.3, 95% CI 1.7, 6.4).
Conclusions: A substantial number of adolescent ED females with lower abdominal pain were diagnosed with PID. Appropriate treatment for PID was provided to the majority of, though not all, patients.
Implications for Programs, Policy, and Research: Given the high prevalence of PID, research and policy efforts should aim to increase both ED-based evaluation for PID and provider adherence to CDC PID treatment guidelines.