Pelvic inflammatory disease in adolescents

More than 1 million cases of pelvic inflammatory disease (PID) are diagnosed annually in the United States. The greatest risk of PID is seen among adolescent girls who are biologically susceptible and socio-behaviorally predisposed, and are also exposed to the long term sequela of recurrent infections. The roles of Neisseria gonorrhea and Chlamydia trachomatis, both organisms previously implicated in majority of PID infections is on the decline, and newer agents are increasingly being isolated. The Clinical presentation of PID are often nonspecific and require a high index of suspicion for diagnosis. In response to the rising incidence of PID, the CDC's new and expanded treatment guideline emphasizes the need for prompt identification and initiation of effective broad spectrum antimicrobial treatment, sexual contact tracing and regular screening of women younger than 25 years. Similar treatment guidelines are used by countries across the world, and subtle differences in regimens reflect variations in treatment cost, availability and prevalent organisms in the region. Current and future research must focus on the development of an effective vaccine and the integration of evidence based community centered strategies for preventing and managing adolescents with PID.