I'm glad to hear things are now on the right track. You seem to have found a wise provider in the urgent care clinic -- although I doubt gonorrhea is the problem.
There are no definitive tests for PID. Sometimes a pelvic untrasound examination or CT scan are done, but usually the diagnosis is made on clinical grounds -- symptoms, pevlic exam, etc. There also are no routine tests to look for PID outcomes, unless there are later problems with fertility. Most patients do fine after treatment of PID, with no long term side effects.
With you advice, I went to an urgent care office. Thank you for your advice, you helped me realize what I had felt was real and serious despite what I had been told.
The doctor seemed pretty surprised that my gyno blew off the pelvic pain as well. He was concerned that I had PID. He was also confused as to why they prescribed me azithromycin again since the first treatment obviously didn't work. He thought that they probably didn't believe I wasn't sexually active (frustrating!). One of his thoughts on the pelvic pain was that I possibly had gonorrhea in my fallopian tubes that wasn't detectable with the STD testing my doctors used. I was prescribed doxyxycline 2x day for ten days. They also gave me a shot of Rocephin, 1 gram. Whew, was that painful.
I will be going back to my gyno around the week of Feb 7th and I'll be sure to give them all this information. Hopefully permanent damage hasn't been done. With all of this going on for weeks now, what kind of outcome should I expect with this diagnosis? What kind of tests would be done to determine PID if any?
Thanks again for your help!
Welcome to the STD clinic. I'll try to help. I have seen your follow-up note below, i.e. initial diagnosis November last year.
I don't think there is anything mysterious here. Azithromycin is highly reliable against chlamydia, but not perfect. The cure rate probably is around 95-98%, i.e. 1 in 20 to 1 in 50 treated patients will have persistent infection. There is a slight possibility your follow-up chlamydia test is false; the lab tests for chlamydia are not perfect. But treatment failure is more likely. The standard recommendation in this situaiton is to be treated with doxyxycline (not single dose, requires 7 days treatment) which always works if azithromycin fails.
As for your pelvic pain, however, I agree with your concern about PID, and I'm a little surprised your doctor seems to have blown this off. Perhaps s/he is unaware that azithromycin sometimes fails to cure chlamydia. You need to return immediately for reevaluation -- or if your own doctor still isn't responsive, find someone else. One way or the other, please do not delay; with the weekend upon us, you may need to visit an urgent care clinic.
Please return with a follow-up comment to let me know how this shakes out.
Regards-- HHH, MD
Sorry doc I gave you a wrong date...Nov '10. Got my years mixed up there!