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Bekkeninfeksjon, akutt

Sist oppdatert: Sist revidert:
Sist revidert av:

Definisjon:
Akutt bakteriell infeksjon i endometriet, tubene, bekkenperitoneum og ev. ovariene
Forekomst:
Hyppigst blant unge, seksuelt aktive kvinner med flere partnere
Symptomer:
Bekkensmerter og utflod, noen har feber og allmennsymptomer, blødningsforstyrrelser, dyspareuni, urinveissymptomer
Funn:
Typiske funn er betent livmorhals og unormal utflod. Livmor eller adnex er ømme ved palpasjon
Diagnostikk:
Klinisk diagnose. I tillegg PCR for klamydia, mycoplasma og gonoré samt dyrkning for gonoré og andre agens. CRP
Behandling:
Antibiotika og hvile. Innleggelse i alvorlige tilfeller
  1. Curry A, Williams T, Penny ML. Pelvic Inflammatory Disease: Diagnosis, Management, and Prevention. Am Fam Physician. 2019; 100(6): 357-364. PMID: 31524362 PubMed  
  2. Rygh A, Kvalvik SA, Moksnes LR, Spydslaug A. Gynekologiske infeksjoner og vulvovaginitt. Akutt bekkeninfeksjon (PID). Veileder i gynekologi. Sist rev. 2021. www.legeforeningen.no  
  3. Davies B, Turner KME, Frølund M et al.; Danish Chlamydia Study Group. Risk of reproductive complications following chlamydia testing: a population-based retrospective cohort study in Denmark. Lancet Infect Dis. 2016 Sep;16(9):1057-1064. Epub 2016 Jun 8. PMID: 27289389 PubMed  
  4. Savaris RF, Fuhrich DG, Maissiat J et al. Antibiotic therapy for pelvic inflammatory disease. Cochrane Database of Systematic Reviews 2020, Issue 8. Art. No.: CD010285. DOI: 10.1002/14651858.CD010285.pub3. Accessed 18 January 2022. The Cochrane Library  
  5. Helsedirektoratet (2021). Nasjonal faglig retningslinje for antibiotika i primærhelsetjenesten nettdokument. Oslo: Helsedirektoratet (sist faglig oppdatert 16. november 2021, lest 16. november 2021).
  6. Soper DE. Pelvic inflammatory disease. Obstet Gynecol 2010; 116: 419-28. PubMed  
  7. Brunham RC, Gottlieb SL, Paavonen J. Pelvic Inflammatory Disease. N Engl J Med 2015; 372: 2039-48. pmid:25992748 PubMed  
  8. Sufrin CB, Postlethwaite D, Armstrong MA, et al. Neisseria gonorrhea and Chlamydia trachomatis screening at intrauterine device insertion and pelvic inflammatory disease. Obstet Gynecol 2012; 120: 1314-21. PubMed  
  9. Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015. MMWR Recomm Rep 2015;64(No. RR-3): 1-137.
  10. Tepper NK, Steenland MW, Gaffield ME et al. Retention of intrauterine devices in women who acquire pelvic inflammatory disease: a systematic review. Contraception. 2013 May;87(5):655-60. Epub 2012 Oct 4. PMID: 23040135 PubMed  
  11. Levin G, Dior UP, Gilad R et al. Pelvic inflammatory disease among users and non-users of an intrauterine device. J Obstet Gynaecol. 2021 Jan;41(1):118-123. Epub 2020 Mar 9. PMID: 32148134 PubMed  
  12. Centers for Disease Control and Prevention. Sexually Transmitted Infections Treatment Guidelines, 2021. Pelvic inflammatory disease (PID). Last reviewed Jul 22, 2021. Accessed Jan 18, 2022
  13. Ross J, Cole M, Evans C, Lyons D, Dean G, Cousins D. United Kingdom National Guidelines for the Management of Pelvic Inflammatory Disease (2019 Interim Update). BASHH Guidelines. Siden besøkt 18.01.22.
  14. Folkehelseinstituttet, Smittevernveilederen. Chlamydiainfeksjon, genital (klamydia) - veileder for helsepersonell. Sist oppdatert 10.06.2019. Siden besøkt 02.03.2020. www.fhi.no  
  15. Haggerty CL, Gottlieb SL, Taylor BD, Low N, Xu F, Ness RB. Risk of sequelae after Chlamydia trachomatis genital infection in women. J Infect Dis 2010; 201(suppl 2): S134-S155.
  16. Gottlieb SL, Berman SM, Low N. Screening and treatment to prevent sequelae in women with Chlamydia trachomatis genital infection: how much do we know? J Infect Dis 2010; 201(suppl 2): S156–S167.
  17. Savaris RF, Fuhrich DG, Duarte RV et al. Antibiotic therapy for pelvic inflammatory disease. Cochrane Database of Systematic Reviews 2017, Issue 4. Art. No.: CD010285. DOI: 10.1002/14651858.CD010285.pub2. The Cochrane Library  
  18. Terao M, Koga K, Fujimoto A, et al. Factors that predict poor clinical course among patients hospitalized with pelvic inflammatory disease. J Obstet Gynaecol Res. 2014;40:495-500. PubMed  
  • Silje Folven Barlindhaug, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Åsa Rytter Evensen, dr. med., spesialist i allmennmedisin, Røa Helsesenter, Oslo kommune
  • Inger Marie Steinsholt, spesialist i allmennmedisin, A/S Legekontoret, Kongsberg