COMMONLY USED DIAGNOSTIC-CRITERIA FOR PELVIC INFLAMMATORY DISEASE HAVE POOR SENSITIVITY FOR PLASMA-CELL ENDOMETRITIS

Background: The majority of women with tubal damage do not have a hist ory of acute pelvic inflammatory disease. The prevalence of upper geni tal tract inflammation was evaluated in women deemed not to have pelvi c inflammatory disease by common diagnostic criteria. Goal of this Stu dy: To compare clinical signs and laboratory tests used to diagnose pe lvic inflammatory disease with endometrial biopsy histopathology. Stud y Design: Endometrial biopsy and commonly used physical and laboratory tests were performed on 52 women with pelvic tenderness, 51 with vagi nosis or cervicitis, and 22 control subjects who had no evidence of in fection with Neisseria gonorrhoeae or Chlamydia trachomatis and who te sted negative for bacterial vaginosis using vaginal swab Gram's stain. Results: Thirty-six of 52 patients (69%) with pelvic tenderness, comp ared with 22 of 51 patients (43%) with vaginosis or cervicitis and two Of 22 control subjects (9%), had plasma cell endometritis. The Center s for Disease Control and Prevention minimal diagnostic criteria for p elvic inflammatory disease had a sensitivity of 33% for plasma cell en dometritis. Conclusions: The clinical diagnosis of pelvic inflammatory disease using published criteria correlates poorly with plasma cell e ndometritis.