What causes acute pelvic inflammatory disease?

There are many causes of acute pelvic inflammatory disease, the most important of which is infection by some pathogens. The more common ones are mycoplasma and chlamydia, as well as streptococci, anaerobic bacteria, in addition Escherichia coli, Staphylococcus aureus, etc., can all cause acute pelvic inflammatory disease. Patients with acute pelvic inflammatory disease will have certain symptoms. At this time, they need to go to the hospital for treatment in time to avoid recurrence of the disease.

(1) Common pathogens: Common pathogens include streptococci, staphylococci, Escherichia coli, anaerobic bacteria, gonococci, chlamydia, mycoplasma, etc.

1. Neisseria gonorrhoeae

About one-third of patients with pelvic inflammatory disease have gonococci cultured from the secretions of the fallopian tubes or uterine rectal fossa, and mixed gonococcal infections can be found in patients with endogenous bacterial infections. Gonorrhea is spread during sexual intercourse, spreading upward through the vagina, cervix, or urethra. 10% to 17% of patients develop gonococcal pelvic inflammatory disease.

2. Chlamydia trachomatis

Chlamydia trachomatis is the leading cause of pelvic inflammatory disease. Among patients with pelvic inflammatory disease, Chlamydia trachomatis can be cultured in 20% of patients, and mixed infection of Chlamydia trachomatis and gonococci accounts for 25% to 40%. The U.S. Centers for Disease Control and Prevention therefore classifies pelvic inflammatory disease as a sexually transmitted disease.

3. Mycoplasma

Mycoplasma can be detected in 43% of patients with postpartum fever of unknown cause.

4. Endogenous aerobic bacteria

Bacteria in the lower genital tract flora are the second largest group of pathogens in pelvic inflammatory disease.

(1) Streptococcus: The most common pathogen of infection is β-hemolytic streptococcus, most of which come from the rectum and can also be transmitted through sexual intercourse. Patients often have no symptoms.

(2) Staphylococcus: It is often the pathogen of wound infection or breast infection. The most common ones are Staphylococcus aureus and Staphylococcus epidermidis. In recent decades, pelvic inflammatory disease caused by Staphylococcus has decreased significantly, but it still occupies an important position in postoperative infection.

(3) Escherichia coli: 15% to 30% of patients are infected with Escherichia coli, which is an important pathogen of postpartum endometritis.

5. Endogenous anaerobic bacteria

The proportion of anaerobic bacteria in pelvic inflammatory disease pathogens is becoming increasingly important and has become an important pathogen.

(1) Peptococcus and Peptostreptococcus: They are prone to grow in necrotic decidua or placental remnants, causing puerperal infection.

(2) Bacteroides fragilis: They are present in large numbers in the normal intestine. The infection is often protracted and there is a strange smell in the secretions.

6. Bacillus perfringens

Bacillus perfringens is the main pathogen of traumatic infection and gas gangrene. The infection is serious and can easily spread outside the pelvic cavity, causing hypotension, renal failure, hemolysis, etc.