What are the clinical manifestations of acute pelvic inflammatory disease?

Patients with acute pelvic inflammatory disease often present with acute illness, increased body temperature, accelerated heart rate, abdominal distension, tenderness and rebound pain in the lower abdomen, and muscle tension, and bowel sounds will weaken or even disappear. Pelvic examination: The vagina may be congested and have a lot of purulent secretions. Wipe the secretions on the surface of the cervix clean. If you see purulent secretions flowing out of the cervical opening, it indicates that there is acute inflammation in the cervical mucosa or uterine cavity.

Acute pelvic inflammatory disease is more common in menstruating, sexually active women. Inflammation can be limited to one site or affect several sites at the same time. The most common are salpingitis and salpingo-oophoritis, while simple endometritis or oophoritis are less common. Pelvic inflammatory disease is divided into two categories: acute and chronic. Acute pelvic inflammatory disease mainly includes acute endometritis, acute salpingitis, acute tubo-ovarian abscess, acute pelvic peritonitis, and acute pelvic connective tissue inflammation. The development of acute pelvic inflammatory disease can cause diffuse peritonitis, sepsis, septic shock, and in severe cases can be life-threatening. If it is not completely cured in the acute stage, it will turn into chronic pelvic inflammatory disease, which is often long-lasting and may recur, leading to infertility, tubal pregnancy, and chronic pelvic pain, which not only seriously affects women's health, life and work, but also creates a burden on the family and society.

Differential diagnosis of pathological leucorrhea:

1. Purulent leucorrhea: yellow or yellow-green in color, sticky or foamy, with a foul odor. It is mostly caused by vaginal inflammation, among which Trichomonas vaginitis is the most common, and is often accompanied by vulvar itching. It can also be seen in chronic cervicitis, senile vaginitis, endometritis, mesometrial effusion or foreign bodies in the vagina.

2. Cheese-like leucorrhea or tofu-like leucorrhea: These are typical symptoms of candidal vaginitis, often accompanied by severe vulvar itching.

3. Bloody leucorrhea: If there is blood in the leucorrhea, you should be alert to the possibility of malignant tumors such as cervical cancer and endometrial cancer. However, benign lesions such as cervical polyps, cervical erosion, submucosal myoma, dysfunctional uterine bleeding, urethral caruncle, senile vaginitis, etc. can also cause bloody leucorrhea. Bloody leucorrhea caused by intrauterine contraceptive device is also more common.

4. Yellow watery leucorrhea: It often occurs after continuous vaginal bleeding, with a large amount of purulent and foul-smelling leucorrhea flowing out of the vagina. Advanced cervical cancer, endometrial cancer or submucosal fibroids with infection should be considered first. Those with paroxysmal discharge should be aware of the possibility of fallopian tube cancer.

5. Urinary dysfunction with increased leucorrhea: In typical gonococcal infection, leucorrhea is like urethral secretions, with increased amount, yellow purulent, and showing signs of intense inflammatory reaction. The leucorrhea caused by chlamydia in cervicitis is less viscous and has an increase in white serous cervical secretions. Excessive leucorrhea and increased leucorrhea are symptoms. The first step in prevention and treatment is to pay attention to personal hygiene. At the same time, anyone with increased leucorrhea (except physiological) should seek medical attention in time, find out the cause under the guidance of a doctor, make timely causal treatment and treatment, and achieve early detection, early prevention, early treatment, and early recovery. Never blindly abuse drugs.

The selection of antibiotics is more reasonable based on drug sensitivity tests, but before the test results are obtained, it is necessary to speculate on the pathogen based on the medical history and clinical characteristics. Since the pathogens of acute pelvic inflammatory disease are mostly mixed infections of aerobic bacteria, anaerobic bacteria and chlamydia, and aerobic bacteria and anaerobic bacteria are divided into Gram-negative and Gram-positive, more attention should be paid in the choice of antibiotics.