Laboratory tests for pelvic inflammatory disease

1. Direct smear of secretions

The samples can be vaginal, cervical secretions, or urethral secretions, or peritoneal fluid (obtained through the posterior fornix, abdominal wall, or through laparoscopy), and direct thin-layer smears are made, which are dried and stained with methylene blue or Gram. Anyone who sees Gram-negative diplococci in polymorphonuclear leukocytes is infected with gonorrhea. Because the detection rate of cervical gonorrhea is only 67%, a negative smear cannot exclude the presence of gonorrhea, and a positive smear is very specific. Fluorescein monoclonal antibody dye can be used for microscopic examination of Chlamydia trachomatis. Any star-shaped flashing fluorescent dots observed under a fluorescence microscope are positive.

2. Pathogen Culture

The specimens are from the same source as above. They should be inoculated on Thayer-Martin medium immediately or within 30 seconds and cultured in a 35°C incubator for 48 hours to identify bacteria by glycolysis. The new relatively rapid chlamydial enzyme assay has replaced the traditional chlamydia detection method. Chlamydia trachomatis antigen detection can also be performed using mammalian cell culture. This method is an enzyme-linked immunosorbent assay. The average sensitivity is 89.5% and the specificity is 98.4%.

Bacteriological culture can also obtain other aerobic and anaerobic strains and serve as a basis for selecting antibiotics.

3. Posterior fornix puncture

Posterior fornix puncture is one of the most commonly used and valuable diagnostic methods for gynecological acute abdomen. Through puncture, the abdominal contents or uterine rectal fossa contents obtained, such as normal peritoneal fluid, blood (fresh, old, clotted blood, etc.), purulent secretions or pus, can further clarify the diagnosis, and microscopic examination and culture of the punctured material are even more necessary.

4. Ultrasound examination

Mainly B-mode or grayscale ultrasound scanning and filming, this technology has an 85% accuracy in identifying masses or abscesses formed by adhesions of the fallopian tubes, ovaries and intestines. However, mild or moderate pelvic inflammatory disease is difficult to show characteristics in B-mode ultrasound images.

5. Laparoscopy

If it is not diffuse peritonitis and the patient's general condition is good, laparoscopy can be performed on patients with pelvic inflammatory disease or suspected pelvic inflammatory disease and other acute abdominal diseases. Laparoscopy can not only make a clear diagnosis and differential diagnosis, but also make a preliminary judgment on the severity of pelvic inflammatory disease.

6. Examination of male partners

This helps in the diagnosis of female pelvic inflammatory disease. The urethral secretions of the male partner can be directly smeared or cultured for gonorrhea. If positive, it is a strong evidence, especially in those who are asymptomatic or have mild symptoms. Or more white blood cells can be found. If all male partners of PID patients are treated, regardless of whether they have symptoms of urethritis, it is obviously very meaningful to reduce recurrence.