Case Study Analysis Of Pelvic Inflammatory Disease Discussion

Case Study Analysis Of Pelvic Inflammatory Disease Discussion

Case Study Analysis

Case Summary

The case study revolves around a 32-year-old female who presents to the emergency department with complains of fever, chills, nausea, and vaginal discharge. After some tests, the patient showed some signs and warning symptoms of Pelvic Inflammatory Disease (PID). A pelvic exam showed that the patient had a foul-smelling drainage and a reddened cervix that was tender. There were clue cells available showing a disruption in the vagina microbiome. At the same time, the patient has gram-negative diplococci, which is a type of bacteria that is sexually transmitted. All these symptoms are warning signs of PID, an infection of a female’s reproductive organs that occurs when sexually-transmitted bacteria spreads from the vagina to the uterus, ovaries, and fallopian tubes (Trent et al., 2016). Based on this case, this study expounds on impact of Sexually-Transmitted Diseases (STDs) on fertility, inflammatory markers in STDs and PUD, reasons for infection, and describes the causes of a systemic reaction from infection Case Study Analysis Of Pelvic Inflammatory Disease Discussion.

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Factors that Affect Fertility (STDs)

From the case study, it is determined that the patient could have PID. According to Mwatelah et al. (2019), PID is often caused by STDs, gonorrhea and chlamydia, when the bacteria causing these diseases enter the reproductive system. PID results in scarring of the cervix, vagina, and uterus, when left untreated, it could have an irreversible damage on one’s fertility. After three episodes of PID, infertility shoots to 50%. PID increases the risk of ectopic pregnancy, where the fertilized egg is trapped in the tube and grows from there, which could burst and cause internal bleeding id not noticed early. Mainly, these are some of the complications of PID hence explaining the need to treat the patient with utmost urgency.

Why Inflammatory Markers Rise in STD/PID

STDs and PID increase inflammatory responses by triggering interactions with the epithelial barrier and immune cells at an infection site. Notably, these diseases trigger an inflammatory response by weakening the mucosal barrier. More so, Kreisel et al. (2021) argues that STDs use different immune evasive techniques that dampen the immune response and augment their persistence. In the patient, the C-reactive protein levels are relatively high, which is 67mg/l and a high sedimentary rate of 46 mm/hr. All these are inflammatory markers that suggest that the patient has an inflammation triggered by the PID Case Study Analysis Of Pelvic Inflammatory Disease Discussion.

Why Infection Happens

PID occurs due to sexually transmitted infection and diseases such as gonorrhea and chlamydia. Accordingly, these bacteria affect the cervix and can be easily treated using antibiotics. When untreated, the bacteria move up the female reproductive organs to the pelvis, uterus, ovaries, and fallopian tubes. Within a year of untreated STDs and STIs, the bacteria develop into PID (Trent et al., 2016). The patient claimed to be faithful to her husband. Nonetheless, from the symptoms and condition, one may argue that she is either not honest or the husband is not monogamous. Her condition could have emanated from untreated STDs and STIs.

Causes of Systemic Reaction From PID

Women with PID tend to have abdominal and pelvic pain, vaginal discharge, and in some instances, vaginal bleeding. The pain is thought to be as a result of an inflammation, scarring, and adhesion resulting from an infectious process. Notably, this pain could manifest as lower back pain or abdominal pain, all seen in the physical symptoms of the patient. Just like any other infection, a patient with PID could have fever symptoms. The green-smelling discharge from the vagina and the reddened cervix are evident that an STI has moved up through the cervix and the reproductive organs Case Study Analysis Of Pelvic Inflammatory Disease Discussion.

Reference

Kreisel, K. M., Llata, E., Haderxhanaj, L., Pearson, W. S., Tao, G., Wiesenfeld, H. C., & Torrone, E. A. (2021). The Burden of and Trends in Pelvic Inflammatory Disease in the United States, 2006–2016. The Journal of Infectious Diseases, 224(Supplement_2), S103–S112. https://doi.org/10.1093/infdis/jiaa771

Mwatelah, R., McKinnon, L. R., Baxter, C., Abdool Karim, Q., & Abdool Karim, S. S. (2019). Mechanisms of sexually transmitted infection‐induced inflammation in women: implications for HIV risk. Journal of the International AIDS Society, 22(S6). https://doi.org/10.1002/jia2.25346

Trent, M., Das, B., & Ronda, J. (2016). Pelvic inflammatory disease: improving awareness, prevention, and treatment. Infection and Drug Resistance, Volume 9, 191–197. https://doi.org/10.2147/idr.s91260 Case Study Analysis Of Pelvic Inflammatory Disease Discussion

Assignment (1- to 2-page case study analysis)

Your Case Study Analysis is related to the scenario provided. You need at least 3 primary references, points supported by citation and associated current, primary reference provided after each essay. Textbook readings are very helpful and will reinforce knowledge culled from readings, reflected in final exam questions.

Please ignore the rubric for this week only. There have been errors asking for point development not related to your case. You will earn full credit by developing the 4 points asked for as follows:

The factors that affect fertility (STDs).
Why inflammatory markers rise in STD/PID.
Why infection happens.
Explain the causes of a systemic reaction from infection (Lab values, Vital Signs, physical presentation, and exam)Case Study Analysis Of Pelvic Inflammatory Disease Discussion.

Module 7: Case Study Analysis Assignment

By Day 1 of Week 10

Scenario 1: A 32-year-old female presents to the ED with a chief complaint of fever, chills, nausea, vomiting, and vaginal discharge. She states these symptoms started about 3 days ago, but she thought she had the flu. She has begun to have LLQ pain and notes bilateral lower back pain. She denies dysuria, foul-smelling urine, or frequency. States she is married and has sexual intercourse with her husband. PMH negative.

Labs: CBC-WBC 18, Hgb 16, Hct 44, Plat 325, Neuts & Lymphs, sed rate 46 mm/hr., C-reactive protein 67 mg/L CMP wnl

Vital signs T 103.2 F Pulse 120 Resp 22 and PaO₂

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99% on room air. Cardio-respiratory exam WNL with the exception of tachycardia but no murmurs, rubs, clicks, or gallops. Abdominal exam + for LLQ pain on deep palpation but no rebound or rigidity. The pelvic exam demonstrates copious foul-smelling green drainage with the reddened cervix and + bilateral adnexal tenderness. + chandelier sign. Wet prep in ER + clue cells and gram stain in ER + gram-negative diplococci.

The case reflects PID. One would suspect the patient is not forthcoming or the husband is not monogamous.

The factors that affect fertility (STDs).
Why inflammatory markers rise in STD/PID.
Why infection happens.
Explain the causes of a systemic reaction from infection (Lab values, Vital Signs, physical presentation, and exam)Case Study Analysis Of Pelvic Inflammatory Disease Discussion