title: Group A Streptococcus causing PID from an initial pharyngeal infection. A case report.
abstract: BACKGROUND
  Pelvic inflammatory disease (PID) is a difficult diagnosis. Five billion dollars is spent on over 1 million women diagnosed each year. Atypical organisms and prior history of tubal ligation may complicate the diagnosis.
  
  
  METHODS
  A woman who had undergone tubal ligation and abstained from intercourse for over two years developed group A streptococcal salpingitis. It occurred following an upper respiratory infection with the same organism.
  
  
  CONCLUSIONS
  PID is rare in a woman with prior tubal ligation who is not engaging in intercourse. In this case it followed an upper respiratory infection with group A Streptococcus. Low diagnostic suspicion must be maintained for uncommon pathogens in PID in women with prior tubal ligation who are not engaging in intercourse.
authors.affiliation: Department of Obstetrics and Gynecology, St. Luke's Hospital, Bethlehem, Pennsylvania 18015, USA. elizabethl@pol.com
authors.forename: E K
authors.initials: EK
authors.lastname: Lamb
authors.forename: J N
authors.initials: JN
authors.lastname: Anasti
authors.forename: H B
authors.initials: HB
authors.lastname: Leonetti
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D010612:Pharyngitis / Q000150:complications* / Q000382:microbiology; D012488:Salpingitis / Q000175:diagnosis* / Q000382:microbiology; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis*; D013297:Streptococcus pyogenes / Q000302:isolation & purification*