ED Pathway for Evaluation/Treatment of Post-Pubertal Girls with Lower Abdominal Pain and No Vaginal Bleeding

Diagnosis of PID

Minimum Criteria Elaborate Criteria* Most Specific Criteria

Uterine/adenexal tenderness
Cervical motion tenderness

Oral temperature > 38.3°C Ultrasound showing thickened, fluid-filled tubes with or without free pelvic fluid or tubo-ovarian complex
  Abnormal cervical or vaginal mucopurulent discharge Laparoscopic findings
  Presence of WBCs on Gram stain of vaginal secretions  
  Elevated ESR  
  Elevated CRP  
  Laboratory documentation of GC, Chlamydial infection  
* Improves specificity, not necessary to initiate treament

2006 STD Guidelines