Acute exacerbation of recurrent pelvic inflammatory disease - Laparoscopicfindings in 141 women with a clinical diagnosis

OBJECTIVE: To evaluate the accuracy of the clinical diagnosis of recurrent pelvic inflammatory disease (PID) and to determine the positive and negativ e predictive value of laboratory tests for the diagnosis of PID. STUDY DESIGN: According to a prospective study design, 141 consecutively ho spitalized patients with the clinical diagnosis of PID were evaluated. The basic inclusion criterion was a history of at least one episode of PID. Sta ndard laboratory tests were performed, specimens for aerobic and anaerobic culture and for Chlamydia trachomatis isolation were obtained, and temperat ure was regularly monitored. All patients underwent laparoscopy under gener al anesthesia within 24 hours of admission. RESULTS: The clinical diagnosis of PID was confirmed by laparoscopy the pel vic organs were within normal limits. Adhesions without signs of PID were f ound in 16%. The third-most-frequent finding was endometriosis (14%). Neith er the individual monitored parameters nor their combination reached satisf actory positive and negative predictive values for diagnosing PID. CONCLUSION: Recurrent clinical symptoms and laboratory signs of PID should be an indication for confirming or excluding the clinical diagnosis by lapa roscopy.