Kim Mi-Hee, Ahn Hyojin, Kang Soyeon, Lee Ahra, Wie Seong-Heon
Division of Infectious Diseases, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Division of Infectious Diseases Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean J Intern Med. 2025 May;40(3):482-490. doi: 10.3904/kjim.2024.213. Epub 2025 Apr 30.
BACKGROUND/AIMS: This study aimed to investigate co-occurrence and clinical characteristics of sexually transmitted infections (STIs) and pelvic inflammatory disease (PID) in women hospitalized for acute pyelonephritis (APN).
This single-center retrospective study reviewed medical records of inpatients with APN from January 2019 to February 2023 and identified records of 142 patients who were referred to a gynecologist to evaluate gynecological diseases including STIs.
Of the 142 patients, 47 were tested positive for sexually transmitted pathogens in nucleic acid amplification testing, confirming the presence of STIs. In patients with APN, those with STIs were more likely to have lower abdominal pain or cervical motion tenderness (CMT) on pelvic examination and leukocytosis (> 14.5 × 109/L) than those without STIs. Of the 93 patients who underwent pelvic examination, 34 had CMT with one or more of additional criteria for the clinical diagnosis of PID, such as abnormal vaginal discharge and leukorrhea confirmed by microscopic examination, which could be clinically diagnosed as PID.
In sexually active women with APN, it is important to evaluate the possibility of STIs and PID, considering several risk factors such as lower abdominal pain, abnormal vaginal discharge, CMT, and leukocytosis.
背景/目的：本研究旨在调查因急性肾盂肾炎（APN）住院的女性中性传播感染（STIs）和盆腔炎（PID）的共现情况及临床特征。
这项单中心回顾性研究回顾了2019年1月至2023年2月期间APN住院患者的病历，并确定了142名被转诊至妇科医生处评估包括性传播感染在内的妇科疾病的患者记录。
在这142名患者中，47名在核酸扩增检测中性传播病原体呈阳性，证实存在性传播感染。在APN患者中，患有性传播感染的患者比没有性传播感染的患者在盆腔检查时更有可能出现下腹部疼痛或宫颈举痛（CMT）以及白细胞增多（>14.5×10⁹/L）。在接受盆腔检查的93名患者中，34名有宫颈举痛，并伴有一项或多项PID临床诊断的附加标准，如显微镜检查证实阴道分泌物异常和白带异常，这些患者可临床诊断为PID。
在患有APN且有性行为的女性中，考虑到下腹部疼痛、阴道分泌物异常、宫颈举痛和白细胞增多等多种风险因素，评估性传播感染和PID的可能性很重要。
