STD: TESTING FOR PELVIC INFLAMMATORY DISEASE
Testing for PID requires a pelvic examination. Evidence of infection may include a yellowish discharge from the cervix, and the cervix may be red and bleed easily when it is swabbed—abnormal signs that indicate cervicitis. With a cervical infection, secretions collected on a swab inserted into the opening of the cervix (the os) will be seen to contain white blood cells when examined under a microscope. With PID, there is also pain when the cervix is moved by a finger inserted into the vagina {cervical motion tenderness). There is usually also pain with pressure over the uterus and ovaries. A woman may experience a fever, and a blood test may reveal an elevated white blood cell count.
Occasionally a surgical procedure called a laparoscopy may be performed to help confirm the diagnosis of PID. The procedure is carried out under anesthesia in a hospital. A tiny incision is made below the umbilicus (belly button) and a laparoscope is inserted into the abdomen to enable the health care provider to look directly at the uterus, Fallopian tubes, and ovaries to see if they are infected. An ultrasound study may also be performed, which may show a collection of pus or infected tissue (an abscess) in the ovaries or Fallopian tubes.
A biopsy of the uterus is another means of establishing whether an infection is present.
Tests for sexually transmitted bacteria such as gonorrhea and chlamydia are usually performed. These tests may be negative even when PID is present, because many bacteria can cause PID, and it is not possible to test routinely for some of them in most clinical settings. During the examination, the health care provider will make sure the woman does not have other conditions—such as pregnancy (particularly an ectopic [tubal] pregnancy), appendicitis, irritable bowel syndrome, endometriosis, or bladder infection—that could mimic the symptoms of PID.
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