Peri-implantation pelvic inflammatory disease with normal pregnancy outcome.
OBJECTIVE
To report on the presentation, diagnostic assessment, treatment, and outcome of a case of peri-implantation pelvic inflammatory disease.


METHODS
Case report.


METHODS
Emergency department and gynecology ward of a tertiary university hospital.


METHODS
A 25-year-old multiparous woman in her 1st month of pregnancy.


METHODS
Diagnostic laparoscopy, antibiotic therapy, and pregnancy surveillance.


METHODS
Surveillance and outcome of pregnancy.


RESULTS
The patient presented with abdominal pain and fever 26 days after her last menstrual period. Examination revealed peritoneal irritation and cervical tenderness, with free fluid in the pelvis. Diagnostic laparoscopy was performed, with no evidence of ectopic pregnancy. A significant quantity of yellow purulent fluid was drained from the pelvis, which cultured for Escherichia coli. Antibiotic therapy yielded excellent response. The pregnancy continued, with no complications, to healthy term delivery.


CONCLUSIONS
This rare diagnosis of peri-implantation pelvic inflammatory disease should be considered in the differential diagnosis of abdominal pain in early pregnancy. Timely, rational treatment, including early pelvic drainage and appropriate antibiotic therapy, may save the pregnancy.
Liberty
Gad
G
Department of Obstetrics and Gynecology, Shaare Zedek Medical Center (affiliated with the Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheba), Jerusalem, Israel. liberg@013.net.il
Hyman
Jordana Hadassah
JH
Margalioth
Ehud J
EJ
D015746:Abdominal Pain / Q000175:diagnosis*; D000328:Adult; D010064:Embryo Implantation; D004927:Escherichia coli Infections / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis* / Q000188:drug therapy; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy; D011256:Pregnancy Outcome