Objective: This study examines the rates of gonorrhea (GC) and Chlamydia (CT) in emergency department patients with PID and cervicits who were diagnosed clinically and treated empirically. A secondary goal examines which clinical criteria were present in PID patients testing positive for GC/CT.
Methods: We conducted a retrospective chart review of all emergency department patients diagnosed with PID or cervicitis during a 40 month period (1/07-3/10). Charts were reviewed for laboratory confirmed GC or CT. For patients with positive GC or CT studies, the presence of key clinical criteria used in the diagnosis of PID was tallied.
Results: 1469 patients were diagnosed with cervicitis and 343 patients were diagnosed with PID. Of these patients, 27/1469 (1.8%) and 15/343 (4.4%) were GC positive and 136/1469 (9.3%) and 34/343 (10%) were CT positive. 26 (1.8%) and 9 (2.6%) patients were positive for both infections. 189 (13%) and 58 (17%) were positive for at least one sexually transmitted infection. Of the 58 PID patients with laboratory confirmed GC/CT, the following clinical criteria were present: abdominal pain 58/58; abdominal tenderness 50/58; cervical discharge 47/58; cervical motion tenderness 46/58; adnexal tenderness 32/58; vaginal bleeding 8/58; fever 2/58. Ultrasound was preformed in 27/58 (47%) of the GC/CT positive PID patients with findings suggestive of PID in 12/27 (44%) of ultrasounds. 100% of abnormal ultrasounds were associated with positive GC and/or CT results.
Conclusion: There is a generally low prevalence of gonorrhea and Chlamydia in this patient population diagnosed with cervicitis or PID. There is a very low prevalence of co-infection.