Table 11 --Criteria for the diagnosis of pelvic inflammatory disease

Minimum criteria for the treatment of pelvic inflammatory disease (all 4 criteria must be present)
  1. Lower abdominal tenderness
  2. Bilateral adnexal tenderness
  3. Cervical motion tenderness
  4. No evidence of competing diagnosis (e.g., ectopic pregnancy or appendicitis)

Additional criteria that support a diagnosis of PID include the following:

  1. Oral temperature greater than 101 F (greater than 38.3 C),
  2. Abnormal cervical or vaginal discharge,
  3. Elevated erythrocyte sedimentation rate,
  4. Elevated C-reactive protein, and
  5. Laboratory documentation of cervical infection with N. gonorrhoeae or C. trachomatis.

The definitive criteria for diagnosing PID, which are warranted in selected cases, include the following:

  1. Histopathologic evidence of endometritis on endometrial biopsy,
  2. Transvaginal sonography or other imaging techniques showing thickened fluid-filled tubes with or without free pelvic fluid or tubo-ovarian complex, and
  3. Laparoscopic abnormalities consistent with PID
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