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This is an infection of the female reproductive organs. It usually occurs when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes or ovaries. Many women who develop pelvic inflammatory disease either experience no signs or symptoms or don’t seek treatment. Pelvic inflammatory disease may be detected only later when you have trouble getting pregnant or if you develop chronic pelvic pain.

Symptoms

Signs and symptoms of pelvic inflammatory disease may include:

Pain in your lower abdomen and pelvis
Heavy vaginal discharge with an unpleasant odor
Irregular menstrual bleeding
Pain during intercourse
Fever
Painful or difficult urination
PID may cause only minor signs and symptoms or none at all. PID with mild or no symptoms is especially common when the infection is due to chlamydia.

When to see a doctor

Go to the emergency room if you experience the following severe signs and symptoms of PID:

Severe pain low in your abdomen
Vomiting
Signs of shock, such as fainting
Fever, with a temperature higher than 101 F (38.3 C)

If your signs and symptoms aren’t severe, but they’re persistent, see your doctor as soon as possible. Vaginal discharge with an odor, painful urination or bleeding between menstrual cycles can be associated with a sexually transmitted infection (STI). If these signs and symptoms appear, stop having sex and see your doctor soon. Prompt treatment of an STI can help prevent PID.

Causes

Pelvic inflammatory disease can be caused by a number of bacteria but are most often caused by gonorrhea or chlamydia infections. These bacteria are usually acquired during unprotected sex.

Less commonly, bacteria may enter your reproductive tract anytime the normal barrier created by the cervix is disturbed. This can happen after intrauterine device (IUD) insertion, childbirth, miscarriage or abortion.

Risk Factors of Pelvic inflammatory disease

A number of factors may increase your risk of pelvic inflammatory disease, including:

Being a sexually active woman younger than 25 years old
Having multiple sexual partners
Being in a sexual relationship with a person who has more than one sex partner
Having sex without a condom
Having had an IUD inserted recently
Douching regularly, which upsets the balance of good versus harmful bacteria in the vagina and may mask symptoms that might otherwise cause you to seek early treatment
Having a history of pelvic inflammatory disease or a sexually transmitted infection

Complications

Untreated pelvic inflammatory disease may cause scar tissue and collections of infected fluid (abscesses) to develop in your fallopian tubes and damage your reproductive organs. Complications may include:

Ectopic pregnancy. PID is a major cause of tubal (ectopic) pregnancy. In an ectopic pregnancy, the fertilized egg can’t make its way through the fallopian tube to implant in the uterus. Ectopic pregnancies can cause massive, life-threatening bleeding and require emergency surgery.
Infertility. PID may damage your reproductive organs and cause infertility — the inability to become pregnant. The more times you’ve had PID, the greater your risk of infertility. Delaying treatment for PID also dramatically increases your risk of infertility.
Chronic pelvic pain. Pelvic inflammatory disease can cause pelvic pain that may last for months or years. Scarring in your fallopian tubes and other pelvic organs can cause pain during intercourse and ovulation.

Tests and Diagnosis

Doctors diagnose pelvic inflammatory disease based on signs and symptoms, a pelvic exam, an analysis of vaginal discharge and cervical cultures, or urine tests.

During the pelvic exam, your doctor uses a cotton swab to take samples from your vagina and cervix. The samples are sent to a lab for analysis to determine the organism that’s causing the infection.

To confirm the diagnosis or to determine how widespread the infection is, your doctor may recommend other tests, such as:

Ultrasound. This test uses sound waves to create images of your reproductive organs.
Endometrial biopsy. During this procedure, your doctor removes a small piece of your uterine lining (endometrium) for testing.
Laparoscopy. During this procedure, your doctor inserts a thin, lighted instrument through a small incision in your abdomen to view your pelvic organs.

Treatment and Drugs

Treatment for pelvic inflammatory disease may include:

Antibiotics. Your doctor may prescribe a combination of antibiotics to start taking right away. After receiving your lab test results, your doctor may adjust the medications you’re taking to better match what’s causing the infection.

Usually, your doctor will request a follow-up visit in three days to make sure the treatment is working. Be sure to take all of your medication, even if you start to feel better after a few days. Antibiotic treatment can help prevent serious complications but can’t reverse any damage that’s already been done.

Treatment for your partner. To prevent reinfection with an STI, advise your sexual partner or partners to be examined and treated. Partners can be infected and not have any noticeable symptoms.
Temporary abstinence. Avoid sexual intercourse until treatment is completed and tests indicate that the infection has cleared in all partners.
More-serious cases

Outpatient treatment is adequate for treating most women with pelvic inflammatory disease. However, if you’re seriously ill, pregnant or haven’t responded to oral medications, you may need hospitalization. At the hospital, you may receive intravenous (IV) antibiotics, followed by antibiotics you take by mouth.

Surgery is rarely necessary. However, if an abscess ruptures or threatens to rupture, your doctor may drain it.

In addition, surgery may be performed on women who don’t respond to antibiotic treatment or who have a questionable diagnosis, such as when one or more of the signs or symptoms of PID are absent.

A test called a urinalysis checks a sample of your urine (pee) to see if there’s blood in it. In some cases, you can see blood in your urine. It may make your urine red or reddish brown. But you can have small amounts of blood in your urine that you can’t see. A urinalysis can find a small amount of blood cells in your urine as well as other types of cells, chemicals, and substances.

Having blood in your urine usually isn’t serious. But in some cases, red or white blood cells in your urine may mean that you have a medical condition that needs treatment, such as a urinary tract infection (UTI), kidney disease, or liver disease.

Other names: microscopic urine analysis, microscopic examination of urine, urine test, urine analysis, UA, urine microscopy

What is it used for?

A urinalysis, which includes a test for blood in urine, is used to check your general health, including the health of your urinary tract, kidneys, and liver. The test can also be used to check for other health problems besides blood in urine.

Why do I need a blood in urine test?

Your health care provider may order a urinalysis as part of a routine exam. You may also need this test if you have seen blood in your urine or have other symptoms that could be caused by a problem with your kidneys or urinary tract. These symptoms include:

Painful urination

Frequent urination

Back pain

Abdominal (belly) pain

What happens during a blood in urine test?

You will need to give a urine sample for the test. A health care professional may give you a cleansing wipe, a small container, and instructions for how to use the “clean catch” method to collect your urine sample. It’s important to follow these instructions so that germs from your skin don’t get into the sample:

Wash your hands with soap and water and dry them.

Open the container without touching the inside.

Clean your genital area with the cleansing wipe:

For a penis, wipe the entire head (end) of the penis. If you have a foreskin, pull it back first.

For a vagina, separate the labia (the folds of skin around the vagina) and wipe the inner sides from front to back.

Urinate into the toilet for a few seconds and then stop the flow. Start urinating again, this time into the container. Don’t let the container touch your body.

Collect at least an ounce or two of urine into the container. The container should have markings to show how much urine is needed.

Finish urinating into the toilet.

Put the cap on the container and return it as instructed.

If you have hemorrhoids that bleed or are having your menstrual period, tell your provider before your test. Outside blood could get into your urine sample and affect your test results.

What do the results mean?

Many things can cause blood in urine. Most of them aren’t serious. The blood may be caused by taking certain medicines, intense exercise, sexual activity, or menstruation (having a period).

But blood in your urine may be a sign of a more serious problem, such as:

Infection in the bladder, kidney, or prostate

Bladder or kidney stones

Kidney injury from an accident or sports

A viral infection, including hepatitis(a disease of the liver causing inflammation)

Cancer of the bladder, kidney, or prostate

Enlarged prostate (BPH)

Inflammation of the kidney, urethra, or bladder

A blood disorder

Polycystic kidney disease

Disorders of the ureters(tubes that connect your kidneys to your bladder)

If your test result shows blood in your urine, you may need more tests to find out why. To learn what your results mean, talk with your provider.

Is there anything else I need to know about a blood in urine test?

A blood in urine test is usually part of a routine urinalysis. A urinalysis also measures other substances in the urine, including proteins, acid and sugar levels, cell fragments, and crystals.

Antibiotics are medicines used to fight bacterial infections. Each type of the antibiotics is only effective against certain bacteria. An antibiotic sensitivity test can help find out which antibiotic will be most effective in treating your infection.

The test can also be helpful in finding a treatment for antibiotic-resistant infections. Antibiotic resistance happens when standard antibiotics become less effective or ineffective against certain bacteria. Antibiotic resistance can turn once easily treatable diseases into serious, even life-threatening illnesses.

Other names: antibiotic susceptibility test, sensitivity testing, antimicrobial susceptibility test

What is it used for?

An antibiotic sensitivity test is used to help find the best treatment for a bacterial infection.

Why do I need an antibiotic sensitivity test?

You may need this test if you have an infection that has been shown to have antibiotic resistance or is otherwise hard to treat. These include tuberculosis, MRSA, and C. diff. You may also need this test if you have a bacterial or fungal infection that is not responding to standard treatments.

What happens during an antibiotic sensitivity test?

The test is done by taking a sample from the infected site. The most common types of tests are listed below.

Blood culture

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial.

Urine culture

You will provide a sterile sample of urine in a cup, as instructed by your health care provider.

Wound culture

Your health care provider will use a special swab to collect a sample from the site of your wound.

Sputum culture

You may be asked to cough up sputum into a special cup, or a special swab may be used to take a sample from your nose.

Throat culture

Your health care provider will insert a special swab into your mouth to take a sample from the back of the throat and tonsils.

Are there any risks to the test?

There is very little risk to having a blood culture test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

There is no risk to having a throat culture, but it may cause slight discomfort or gagging.

There is no risk to having a urine, sputum, or wound culture.

What do the results mean?

Results are usually described in one of the following ways:

The tested medicine stopped the growth or killed the bacteria or fungus causing your infection. The medicine may be a good choice for treatment.

The medicine may work at a higher dose.

The medicine did not stop the growth or kill the bacteria or fungus causing the infection. It would not be a good choice for treatment.

If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about an antibiotic sensitivity test?

Incorrect use of antibiotics has played a big role in the rise in antibiotic resistance. Make sure you use antibiotics the right way by:

Taking all doses as prescribed by your provider

Only taking antibiotics for bacterial infections. They don’t work on viruses, like colds and flu.