Pelvic inflammatory disease.

The rising incidence of pelvic inflammatory disease (PID), coupled with the development of more sophisticated and effective diagnostic techniques, has created a new body of knowledge regarding the microbiology, diagnosis, and natural history of this disease. Acute pelvic inflammatory disease is the major gynecologic health problem in the United States. Distinguishing acute PID from the other causes of acute pelvic pain is often a difficult task. Careful consideration of a patient's risk profile for PID and utilization of the diagnostic techniques available are invaluable in helping the clinician accurately make this differentiation. The microbial spectrum involved in PID is complex and must be taken into consideration when selecting an antibiotic regimen. The recent addition of new, broad-spectrum antibiotics to the physician's therapeutic armamentarium has led to increasingly effective management options. Despite the effectiveness of current medical and surgical therapy, the staggering economic, medical, and social consequences of PID mandates more aggressive efforts at its prevention.