A review on pelvic inflammatory disease.

Pelvic inflammatory disease (PID) remains a significant cause of morbidity worldwide, with the potential to result in serious reproductive complications. Much of the definitive work regarding PID was completed in the 1960s and 1970s. More recently, however, there have been a range of studies published that have contributed to our understanding of PID. Aetiologically, the main pathogens are chlamydia and gonorrhoea, but may include Mycoplasma genitalium and anaerobic Gram-negative rods. Risk factors associated with the development of PID include inconsistent barrier contraception, possibly vaginal douching, and the oral contraceptive pill likely masking the clinical severity of the disease. The small risk associated with the intrauterine device is limited to the first few weeks after insertion. New diagnostic techniques being evaluated include Doppler ultrasound and magnetic resonance imaging. Management must be prompt to prevent complications, and there are no apparent differences in clinical outcomes, whether treated as an inpatient or outpatient. Effective disease prevention includes widespread chlamydia screening and improving education.