How should I investigate suspected PID?

Consider the following investigations:

  • Pregnancy test to exclude ectopic pregnancy
  • Urinalysis
  • Bloods tests
    • FBC, U&Es, CRP
    • Blood cultures if febrile and systemically unwell
    • Consider testing for HIV or syphilis with consent if risk factors present
  • Swab for STIs
    • Endocervical swab with nucleic acid amplification test (NAAT) for Chlamydia and Gonorrhoea
    • High vaginal swab: for bacterial vaginosis and Trichomonas
    • First catch urine is an alternative method of testing for STIs although this is less sensitive
  • Ultrasound scan can be considered if an abscess, appendicitis or ovarian cyst are suspected
  • MRI or CT are not recommended to assess PID but may be required to exclude differential diagnoses2,4

Learning bite: any woman of child-bearing age with abdominal pain must have a pregnancy test to rule out ectopic pregnancy