MEDizzy - A 25-year-old woman presents with lower abdominal pain,

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Reproductive Systems and Skin

A 25-year-old woman presents with lower abdominal pain, fever, and a vaginal discharge. Pelvic examination reveals bilateral adnexal (ovarian) tenderness and pain when the cervix is manipulated. Cultures taken from the vaginal discharge grow Neisseria gonorrhoeae. Which of the following is the most likely cause of this patient’s adnexal pain?

ExplanationPelvic inflammatory disease (PID) is a common disorder caused by infection with either gonococci (the most common cause), chlamydiae, or enteric bacteria. Gonococcal infection, seen microscopically as gram-negative intracellular diplococci, begins in the Bartholin glands and then spreads upward to involve the fallopian tubes and tuboovarian regions. This produces PID, which is characterized by pelvic pain, fever, adnexal tenderness, and pain when the cervix is manipulated. Complications of PID include peritonitis from rupture of a tuboovarian abscess, infertility, and intestinal obstruction.