Upper genital tract infections

1. Big picture

Upper genital tract infections are infections above the cervix: endometrium, fallopian tubes, ovaries, pelvic peritoneum, and sometimes perihepatic peritoneum. In practice, the central exam diagnosis is pelvic inflammatory disease (PID).

Think of PID as:

Ascending infection from vagina/cervix
→ endometritis
→ salpingitis
→ oophoritis / tubo-ovarian abscess
→ pelvic peritonitis
→ adhesions, infertility, ectopic pregnancy, chronic pelvic pain

The examiner wants you to recognize this pattern:

Sexually active woman + lower abdominal/pelvic pain
+ cervical motion tenderness / uterine tenderness / adnexal tenderness
± fever, discharge, abnormal bleeding
= treat as PID early

PID is treated early because even mild or subclinical disease can damage the tubes and future fertility. Current guidance defines PID as a spectrum including endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis; sexually transmitted organisms such as Chlamydia trachomatis and Neisseria gonorrhoeae are classic causes, but many cases are polymicrobial with anaerobes and vaginal flora. ([CDC][1])

---