Acute pelvic inflammatory disease: etiology, risk factors and pathogenesis.

It was suggested that several behaviorial factors could be important in allowing mild local symptoms of infection to develop into PID. A localized gonococcal infection may produce an increased vaginal discharge or dysuria. PID results only if several other factors have been operable. Loss of the cervical mucus barrier with menstruation appears to be important in allowing bacteria to pass from the cervix in to the uterine cavity. Uterine infection may account for the abnormal uterine bleeding seen in 40% of all PID patients (18). When N. gonorrhoeae multiples beyond the capabilities of the genital tract defense mechanisms, a bilateral tubal infection ensues...