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22Gynaecology16 min read

Upper genital tract infections

1. Big picture

Upper genital tract infections are infections above the cervix: endometrium, fallopian tubes, ovaries, pelvic peritoneum, and sometimes perihepatic peritoneum. In practice, the central exam diagnosis is pelvic inflammatory disease (PID).

Think of PID as:

Ascending infection from vagina/cervix
→ endometritis
→ salpingitis
→ oophoritis / tubo-ovarian abscess
→ pelvic peritonitis
→ adhesions, infertility, ectopic pregnancy, chronic pelvic pain

The examiner wants you to recognize this pattern:

Sexually active woman + lower abdominal/pelvic pain
+ cervical motion tenderness / uterine tenderness / adnexal tenderness
± fever, discharge, abnormal bl

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