Pelvic Inflammatory Disease

A 28-year-old woman presents with lower abdominal pain, vaginal discharge, and fever for 5 days. On examination, she has cervical motion tenderness and adnexal tenderness bilaterally. Empirical antibiotics have been started. Which investigation is most appropriate to confirm the diagnosis of pelvic inflammatory disease and assess for complications such as tubo-ovarian abscess?

A 32-year-old woman with a history of multiple episodes of pelvic inflammatory disease presents with chronic pelvic pain and infertility. She is being evaluated for structural sequelae of recurrent PID. Which investigation is most appropriate to assess tubal patency and detect intrauterine adhesions or tubal strictures?

A 32-year-old woman with a history of 2 episodes of pelvic inflammatory disease (treated 18 months and 6 months ago) presents with 2 weeks of mild lower abdominal pain, irregular menses, and infertility for 8 months despite regular unprotected intercourse. On examination, she is afebrile, has mild adnexal tenderness, and no cervical discharge. Pelvic ultrasound shows normal ovaries and uterus with no free fluid. Cervical swabs for gonorrhea and chlamydia PCR are negative. What is the most likely cause of her infertility?

A 28-year-old woman presents to the emergency department with a 3-day history of lower abdominal pain, vaginal discharge, and fever (38.5°C). She is sexually active with multiple partners and reports inconsistent condom use. On examination, she has cervical motion tenderness, adnexal tenderness bilaterally, and purulent cervical discharge. Her WBC is 14,500/μL with left shift. Pelvic ultrasound shows thickened fallopian tubes with free fluid in the pelvis. Which of the following is the most appropriate initial management?

A 32-year-old nulliparous woman presents with a 2-week history of lower abdominal pain, dyspareunia, and mucopurulent cervical discharge. She has a history of untreated chlamydial infection 6 months ago. On pelvic examination, she has cervical motion tenderness and left-sided adnexal mass (8 cm) that is tender. Temperature is 37.8°C. Pelvic ultrasound confirms a complex left adnexal mass with internal echoes and septations suggestive of a tubo-ovarian abscess (TOA). WBC is 13,200/μL. What is the most appropriate next step in management?