Sexually transmitted infections in ambulatory patients with pelvic inflammatory disease

Summary

The prevalence of sexually transmitted infections including human immunodeficiency virus (HIV) in women with clinical evidence of mild to moderate pelvic inflammatory disease receiving outpatient management, was determined. Vaginal and endocervical swab specimens were collected for the detection of Trichomonas vaginalis, yeasts, Neisseria gonorrhoeae and herpes simplex virus. Venous blood was collected for syphilis serology, antibody to HIV and hepatitis B surface antigen. Of 45 women studied, 23 had mild and 22 moderate pelvic inflammatory disease. There were no significant differences with regard to isolates and results of serological tests between the two groups. N. gonorrhoeae was isolated in 9 per cent of women with moderate pelvic inflammatory disease and C. trachomatis was detected more frequently in women with moderate disease; 35 per cent versus 23 per cent. Antibody to HIV was found in 13 per cent and 18 per cent of women with mild and moderate pelvic inflammatory disease respectively. The high prevalence of sexually transmitted infections diagnosed in women with pelvic inflammatory disease in Durban, South Africa, has clinical relevance in that treatment protocols for ambulatory patients must include antimicrobial agents active against both N. gonorrhoeae and C. trachomatis, Serological testing for syphilis must be undertaken and appropriate treatment administered. Furthermore, such women should have appropriate counselling and advice with regard to screening for HIV.