Assessment of pelvic inflammatory disease

The diagnosis of pelvic inflammatory disease (PID) is based on clinical assessment. Symptoms of PID include pelvic pain, painful intercourse, vaginal or cervical discharge (purulent or bloody), and abnormal vaginal bleeding (intermenstrual, postcoital or heavy). Also exclude ectopic pregnancy and other abdominal emergencies (eg appendicitis)Ong, 2023.

Investigate suspected pelvic inflammatory disease (PID) with a clinician-collected endocervical swab for:

nucleic acid amplification testing (NAAT) (eg polymerase chain reaction [PCR]) for Chlamydia trachomatis, Neisseria gonorrhoeae, and Mycoplasma genitalium
Gram stain, culture and susceptibility testing for N. gonorrhoeae.

Note: Investigate suspected PID with an endocervical swab.

If speculum examination is not possible, a self-collected¹ vaginal swab or a first-pass² urine sample can be used.

Before starting antibiotic therapy, collect blood samples for culture and susceptibility testing for patients with sepsis or septic shock.

¹ For information on methods of self-collection of vaginal swab samples, see the diagnosis section of the ‘Pelvic inflammatory diseases (PID)’ topic in the Australian STI Management Guidelines for Use in Primary Care.Return

² A first-pass urine specimen is the first part of the urine stream, which can be collected at any time of the day; see the diagnosis section of the ‘Pelvic inflammatory diseases (PID)’ topic in the Australian STI Management Guidelines for Use in Primary Care for more information.Return