How should I investigate suspected PID?
Consider the following investigations:
- Pregnancy test to exclude ectopic pregnancy
- Urinalysis
- Bloods tests
- FBC, U&Es, CRP
- Blood cultures if febrile and systemically unwell
- Consider testing for HIV or syphilis with consent if risk factors present
- Swab for STIs
- Endocervical swab with nucleic acid amplification test (NAAT) for Chlamydia and Gonorrhoea
- High vaginal swab: for bacterial vaginosis and Trichomonas
- First catch urine is an alternative method of testing for STIs although this is less sensitive
- Ultrasound scan can be considered if an abscess, appendicitis or ovarian cyst are suspected
- MRI or CT are not recommended to assess PID but may be required to exclude differential diagnoses2,4
Learning bite: any woman of child-bearing age with abdominal pain must have a pregnancy test to rule out ectopic pregnancy