PID question

[zinaida]

Hello. I wanted to thank you for this forum, very helpful. About 10 years ago, I got an acute fallopian tube infection (left tube); got strong antibiotics and the infection went away. A few months ago I got the pain in my left lower abdominal area, but the pain was very dull and would come and go. Later I started to get small fevers and finally the pain became stronger and started to spread to my right side too. I went to doctor and she took pap smear and tested me for all STDs, all came back normal and negative. Then I went to gynocologist, did ultrasound, all came back OK, and he diagnosed me with PID and prescribed Doxycycline HYC 100MG. I took it for about 9 days and one day woke up with fever 102.3 and really bad pain in my abdominal. Doctor put me into hospital the same day for 48 hours and they gave me Clindamycin Phosphate 900MG and Gentamicin 500MG via IV. After hospital I felt no pain, and doctor told me to finish Doxycyline. In two days pain and fever came back, but my doctor keeps telling me to continue with pain killers and that he will give me another prescription for Doxycycline (1 more week). I fell that I am getting worse. Please, advise me on what to do next.

[H. Hunter Handsfield, M.D.]

Thanks for the thanks about the forum.  But unfortunately, I cannot help. You don't need an STD expert, you need a good gynecologist--and the evidence is you have one.  You don't describe you current STD risks, but even if no such risk, you still could have PID.  That's because one episode of PID predisposes to recurrent Fallopian tube infection with non-STD bacteria.  Part of the evidence that your doctor knows his business is that he treated you exactly the antibiotics that are recommended in that circumstance.  Pain often persists long after PID clears up.  That's really not an STD issue; it can occur following any abdominal infection, and it does not mean that your infection wasn't cured.

So my advice is to continue to follow up with your gynecologist and follow his advice; or if unsatisfied, ask for him to refer you for a second opinion.

Good luck--  HHH, MD

[MLWTR]

Are the docs 100% sure that this is a gynecological issue? For instance, a G.I. problem could also cause abdominal pain and persistent fever. I think I'd be looking for some additional opinions here from specialists outside of the OB/GYN realm. Hope you feel better soon.

[H. Hunter Handsfield, M.D.]

A gynecolgist's diagnosis of PID probably is reliable; and in any case, the antibiotis zinaida was given would be effective against almost any non-gyn intrabdominal infection. It wouldn't be a bad idea to ask the gyn how certain he was about the diagnosis of PID, but zinaida describes no particular reason to be concerned about a wrong diagnosis.