How to diagnose pelvic inflammatory disease
(A) direct smear secretion
Sampling for vaginal, cervical secretions, or urethral secretions, or peritoneal fluid (via the posterior vaginal fornix, abdominal, or laparoscopic access), so direct thin smear, dried with blue or Gram stain. Where PMN double within the gram-negative bacteria to see who was infected with gonorrhea. The detection rate for cervical gonococcal is only 67% smear-negative and therefore can not exist other than gonorrhea, and a positive smear is very specific. Microscopic examination of Chlamydia trachomatis monoclonal antibody fluorescein dye can be used, where the observed fluorescence microscope flashing dots of a star as the positive.
(B) the pathogens
- Specimens from Ibid, immediately or in the 30s will be inoculated in the Thayer-Martin medium, 35 ℃ incubator training set 48h, in order to identify bacteria glycolysis. Relatively fast new chlamydia enzymes instead of the traditional detection of chlamydia, can also be used for mammalian cell culture on antigen detection of Chlamydia trachomatis, the legal systems of enzyme-linked immunosorbent assay. The average sensitivity of 89.5%, with 98.4% specificity.
- Bacterial culture can also be other strains of aerobic and anaerobic bacteria and as the basis for the selection of antibiotics.
(C) of the posterior fornix puncture
Puncture after the dome is the most common gynecological acute abdomen and a valuable diagnostic method. Through the puncture, and the resulting nest abdominal contents or the contents of the uterus rectum, such as the normal peritoneal fluid, blood (fresh, stale, coagulation wire, etc.), purulent secretions or pus, so diagnosis can be further defined, Microscopic examination of biopsy material, and culture are essential.
Mainly B-or gray-scale ultrasound scanning, photo film, the technology for identification from the fallopian tube, ovarian and bowel adhesion formation in the mass or abscess with 85% accuracy. However mild or moderate degree of pelvic inflammatory disease is difficult in the B mode ultrasound image feature in the show.
If not diffuse peritonitis, the patient is still generally good, laparoscopy or suspected pelvic inflammatory disease in pelvic inflammatory disease and other patients in the acute abdomen, laparoscopy was not only the diagnosis and differential diagnosis but also the extent of the pelvic inflammatory disease preliminary determination.
(F) inspection of male partners
This helps the diagnosis of female pelvic inflammatory disease. The desirability of their male partners to make a direct smear of urethral discharge Gonococcus staining or culture, if found positive, it is the strongest evidence, especially in the asymptomatic or the symptoms of mild to severe. Or more of the white blood cells can be found. If PID patients of all men with untreated, regardless of whether they had symptoms of urethritis, then obviously the reduction of recurrence is very significant.