Surd Adrian, Mureșan Rodica, Oprea Andreea, Snakovszki Kriszta, Sur Lucia Maria, Usatiuc Lia-Oxana, Ciongradi Carmen-Iulia, Sârbu Ioan
Pediatric Surgery and Orthopedics, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Pediatric Surgery and Orthopedics, Emergency Children Hospital, 400370 Cluj-Napoca, Romania.
J Clin Med. 2025 Jun 4;14(11):3971. doi: 10.3390/jcm14113971.
Pelvic inflammatory disease (PID), primarily associated with sexually transmitted infections (STIs), represents a diagnostic challenge in virgin pediatric patients due to the often vague, non-specific symptomatology, which can mimic other conditions. Management prioritizes targeted antimicrobial therapy, with surgical intervention reserved for complications like tubo-ovarian abscess (TOA). The present systematic review aimed to critically evaluate the available evidence from case reports of PID in virgin pediatric and adolescent patients. The search strategy was in accordance with PRISMA guidelines. Case reports published up to March 2025 were searched through PubMed, Embase, Scopus, and Google Scholar databases. We included English-language case reports on non-sexually active pediatric and adolescent patients with available full text, excluding commentaries, reviews, and editorials. The Critical Appraisal Checklist for Case Reports was used for the quality assessment of case reports. Through descriptive analysis, PID symptoms, diagnostic, and management modalities were reviewed. The quality of the included case reports was assessed using the JBI Critical Appraisal Checklist. This review was not registered and did not receive external funding. Among the 56 case reports searched, 20 reports were selected and analyzed based on eight criteria. The most frequently reported symptoms were lower abdominal pain (95.8%), fever (63.6%), and gastrointestinal symptoms (50%). Common comorbidities included urinary tract infections (22.7%), congenital anomalies (18.1%), and appendicitis history (18.1%). and species were the predominant pathogens identified. All patients received antibiotic therapy, while 90.9% underwent surgical intervention. Favorable outcomes were achieved in 72.7% of cases, though 27.2% experienced complications or recurrences. Although commonly linked to sexual activity, PID should be considered in sexually inactive pediatric patients presenting with abdominal pain and adnexal masses. Early diagnosis, appropriate imaging, and timely treatment are crucial to improve outcomes and reduce complications. The evidence in this review is limited by its reliance on case reports, which may introduce bias and restrict generalizability.
盆腔炎（PID）主要与性传播感染（STIs）相关，由于症状往往模糊、不具特异性，可能与其他病症相似，因此对于未婚儿科患者来说是一项诊断挑战。治疗重点是针对性的抗菌治疗，手术干预仅用于治疗如输卵管卵巢脓肿（TOA）等并发症。本系统评价旨在严格评估未婚儿科和青少年患者PID病例报告中的现有证据。检索策略符合PRISMA指南。通过PubMed、Embase、Scopus和谷歌学术数据库检索截至2025年3月发表的病例报告。我们纳入了关于无性活跃的儿科和青少年患者且有全文的英文病例报告，排除评论、综述和社论。使用病例报告关键评估清单对病例报告进行质量评估。通过描述性分析，对PID的症状、诊断和治疗方式进行了综述。使用JBI关键评估清单评估纳入病例报告的质量。本综述未注册，也未获得外部资金。在检索到的56篇病例报告中，根据八项标准选择了20篇报告进行分析。最常报告的症状是下腹痛（95.8%）、发热（63.6%）和胃肠道症状（50%）。常见的合并症包括尿路感染（22.7%）、先天性异常（18.1%）和阑尾炎病史（18.1%）。已确定的主要病原体为[此处原文缺失病原体相关内容]和[此处原文缺失病原体相关内容]。所有患者均接受了抗生素治疗，90.9%的患者接受了手术干预。72.7%的病例取得了良好的治疗效果，不过27.2%的患者出现了并发症或复发。虽然PID通常与性活动有关，但对于出现腹痛和附件肿块的无性活跃儿科患者也应考虑该疾病。早期诊断、适当的影像学检查和及时治疗对于改善治疗效果和减少并发症至关重要。本综述中的证据受到其对病例报告的依赖的限制，这可能会引入偏差并限制可推广性。
