Jaiyeoba Oluwatosin, Soper David E
Department of Obstetrics and Gynecology, Medical University of South Carolina, P.O. Box 250619, Charleston, SC 29425, USA.
Infect Dis Obstet Gynecol. 2011;2011:753037. doi: 10.1155/2011/753037. Epub 2011 Jul 26.
The diagnosis of acute pelvic inflammatory disease (PID) is usually based on clinical criteria and can be challenging for even the most astute clinicians. Although diagnostic accuracy is advocated, antibiotic treatment should be instituted if there is a diagnosis of cervicitis or suspicion of acute PID. Currently, no single test or combination of diagnostic indicators have been found to reliably predict PID, and laparoscopy cannot be recommended as a first line tool for PID diagnosis. For this reason, the clinician is left with maintaining a high index of suspicion for the diagnosis as he/she evaluates the lower genital tract for inflammation and the pelvic organs for tenderness in women with genital tract symptoms and a risk for sexually transmitted infection. This approach should minimize treating women without PID with antibiotics and optimize the diagnosis in a practical and cost-effective way.
急性盆腔炎（PID）的诊断通常基于临床标准，即使对最敏锐的临床医生来说也可能具有挑战性。尽管提倡诊断准确性，但如果诊断为宫颈炎或怀疑为急性PID，就应开始使用抗生素治疗。目前，尚未发现单一检测或诊断指标组合能够可靠地预测PID，并且不推荐将腹腔镜检查作为PID诊断的一线工具。因此，临床医生在评估有生殖道症状且有性传播感染风险的女性的下生殖道炎症和盆腔器官压痛时，必须对诊断保持高度怀疑。这种方法应尽量减少对抗生素治疗无PID的女性的治疗，并以实用且具有成本效益的方式优化诊断。
