Diagnostic d'une infection génitale haute : critères cliniques, paracliniques, imagerie, et cœlioscopie. Recommandations pour la pratique clinique Infections Génitales Hautes, CNGOF-SPILF. - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Gynécologie Obstétrique Fertilité & Sénologie Année : 2019

Diagnosis of pelvic inflammatory disease: Clinical, paraclinical, imaging and laparoscopy criteria. CNGOF and SPILF Pelvic Inflammatory Diseases Guidelines.

Diagnostic d'une infection génitale haute : critères cliniques, paracliniques, imagerie, et cœlioscopie. Recommandations pour la pratique clinique Infections Génitales Hautes, CNGOF-SPILF.

Résumé

The objective of this literature review is to update the recommendations for clinical practice about the diagnosis of pelvic inflammatory disease (PID), microbiologic diagnosis excluded. An adnexal pain or cervical motion tenderness are the signs that allow a positive diagnosis of PID (LE2). Associated signs (fever, leucorrhoea, metrorrhagia) reinforce clinical diagnosis (LE2). In a woman consulting for symptoms compatible with PID, a pelvic clinical examination is recommended (grade B). In cases of suspected PID, hyperleukocytosis associated with a high C-reactive protein suggests a complicated PID or a differential diagnosis such as acute appendicitis (LE3). The absence of hyperleukocytosis or normal CRP does not rule out the diagnosis of PID (LE1). When PID is suspected, a blood test with a blood count and a CRP test is recommended (grade C). Pelvic ultrasound scan does not contribute to the positive diagnosis of uncomplicated PID because it is insensitive and unspecific (LE3). However, ultrasound scan is recommended to look for signs of complicated PID (polymorphic collection) or differential diagnosis (grade C). Waiting for an ultrasound scan to be performed should not delay the start-up of antibiotic therapy. In case of diagnostic uncertainty, an abdominal-pelvic CT scan with contrast injection is useful for differential diagnosis of urinary, digestive or gynaecological origin (LE2). Laparoscopy is not recommended for the unique purpose of the positive diagnosis of PID (grade B).
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Dates et versions

hal-02127841 , version 1 (13-05-2019)

Identifiants

Citer

Amélie Charvériat, Xavier Fritel. Diagnostic d'une infection génitale haute : critères cliniques, paracliniques, imagerie, et cœlioscopie. Recommandations pour la pratique clinique Infections Génitales Hautes, CNGOF-SPILF.. Gynécologie Obstétrique Fertilité & Sénologie, 2019, Epub ahead of print. ⟨10.1016/j.gofs.2019.03.010⟩. ⟨hal-02127841⟩

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