TABLE 92.2 DIAGNOSTIC CRITERIA FOR PELVIC INFLAMMATORY DISEASE Minimum criteria Additional criteria Specific criteria Sexually active patient with pelvic or lower abdominal pain, no cause other than PID identified, and one of the following: Cervical motion tenderness or Uterine tenderness or Adnexal tenderness These findings enhance the specificity of the minimum criteria and support a diagnosis of PID: Oral temperature >101°F (>38.3°C) Abnormal cervical or vaginal mucopurulent discharge Abundant numbers of white blood cell on saline microscopy of vaginal secretions Erythrocyte sedimentation rate >15 mm/hr Elevated C-reactive protein Documented gonococcal or chlamydial cervical infection These findings offer a definitive diagnosis of PID: Endometrial biopsy with histopathologic evidence of endometritis Laparoscopic abnormalities consistent with PID Transvaginal sonography or magnetic resonance imaging techniques showing thickened, fluid-filled tubes or tuboovarian complex, or Doppler studies showing tubal hyperemia PID, pelvic inflammatory disease Adapted from Workowski KA, Berman S; Centers for Disease Control and Prevention Sexually transmitted diseases treatment guidelines, 2010 MMWR Recomm Rep 2010;59(RR-12):1–110 Triage Considerations The majority of patients with PID will be stable However, patients presenting with an ill appearance or peritonitis require prompt treatment and surgical consultation These findings may suggest a complication such as a perforated tuboovarian abscess