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Clinical approach to sexually transmitted infections and pelvic inflammatory disease in women with acute pyelonephritis

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Background/Aims: This study aimed to investigate co-occurrence and clinical characteristics of sexually transmitted infections (STIs) and pelvic inflammatory disease (PID) in women hospitalized for acute pyelonephritis (APN). Methods: This single-center retrospective study reviewed medical records of inpatients with APN from January 2019 to February 2023 and identified records of 142 patients who were referred to a gynecologist to evaluate gynecological diseases including STIs. Results: Of the 142 patients, 47 were tested positive for sexually transmitted pathogens in nucleic acid amplification testing, confirming the presence of STIs. In patients with APN, those with STIs were more likely to have lower abdominal pain or cervical motion tenderness (CMT) on pelvic examination and leukocytosis (> 14.5 × 109/L) than those without STIs. Of the 93 patients who underwent pelvic examination, 34 had CMT with one or more of additional criteria for the clinical diagnosis of PID, such as abnormal vaginal discharge and leukorrhea confirmed by microscopic examination, which could be clinically diagnosed as PID. Conclusions: In sexually active women with APN, it is important to evaluate the possibility of STIs and PID, considering several risk factors such as lower abdominal pain, abnormal vaginal discharge, CMT, and leukocytosis.

Abstract

Background/Aims: This study aimed to investigate co-occurrence and clinical characteristics of sexually transmitted infections (STIs) and pelvic inflammatory disease (PID) in women hospitalized for acute pyelonephritis (APN). Methods: This single-center retrospective study reviewed medical records of inpatients with APN from January 2019 to February 2023 and identified records of 142 patients who were referred to a gynecologist to evaluate gynecological diseases including STIs. Results: Of the 142 patients, 47 were tested positive for sexually transmitted pathogens in nucleic acid amplification testing, confirming the presence of STIs. In patients with APN, those with STIs were more likely to have lower abdominal pain or cervical motion tenderness (CMT) on pelvic examination and leukocytosis (> 14.5 × 109/L) than those without STIs. Of the 93 patients who underwent pelvic examination, 34 had CMT with one or more of additional criteria for the clinical diagnosis of PID, such as abnormal vaginal discharge and leukorrhea confirmed by microscopic examination, which could be clinically diagnosed as PID. Conclusions: In sexually active women with APN, it is important to evaluate the possibility of STIs and PID, considering several risk factors such as lower abdominal pain, abnormal vaginal discharge, CMT, and leukocytosis.

참고문헌 (25)

관련 논문AI추천

Clinical investigation on acute pyelonephritis without pyuria: a retrospective observational study나지웅, 신동혁, 이장희, 최필조, 한상국, Hyung Keun Song영남대학교 의과대학 · Journal of Yeungnam Medical Science2022 · 제39권 제1호A comparison of the clinical characteristics of elderly and non-elderly women with communityonset, non-obstructive acute pyelonephritis김형욱, 노용선, 위성헌, 장우임대한내과학회 · The Korean Journal of Internal Medicine2015 · 제30권 제3호Clinical Characteristics and Antimicrobial Susceptibility of Elderly Women with Acute Pyelonephritis김웅빈, 이상욱, Ji Kang Yun, Jun Mo Kim, Kwang Woo Lee, Young Ho Kim대한요로생식기감염학회 · Urogenital Tract Infection2020 · 제15권 제3호Comparison of Escherichia coli and Klebsiella pneumoniae Acute Pyelonephritis in Korean Patients김현아, 류성열, 이지연, 현미리대한감염학회 · Infection and Chemotherapy2019 · 제51권 제2호골반염과 Fitz-Hugh-Curtis syndrome 환자에서 N. gonorrheaee 및 C. trachomatis, U. urealyticum, M. hominis의 빈도조숙, 김혜지, 박철희, 이경훈, 이한나, 전윤정, 최현정대한감염학회 · Infection and Chemotherapy2012 · 제44권 제5호Clinical Usefulness of Procalcitonin as a Predictive Marker in Accordance with the Severity of Female Patients with Uncomplicated Acute Pyelonephritis김영주대한요로생식기감염학회 · Urogenital Tract Infection2016 · 제11권 제3호

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