PID algo v1

  • Adolescent focused History & Physical
    • Send Urine Hcg, Clean UA and Urine Culture
      • Urine Hcg negative?
        • Yes
          • Speculum exam, GC/CT vaginal swab, bimanual exam
            • Adnexal OR Uterine OR Cervical Motion Tenderness?
              • No
                • Exit algorithm
              • Yes
                • Does your patient have any of the following:
                  • Checks
                    • Pelvic or adnexal mass on physical exam
                    • Unilateral tenderness
                    • Cannot adequately assess gynecologic structures on bimanual exam
                    • Highly febrile (>101.5)
                    • Severe Pain
                  • Yes
                    • Obtain pelvic ultrasound
                      • US shows TOA pelvic abscess or ovarian cyst
                        • No
                          • Have alternative diagnoses been excluded?
                            • No
                              • Complete other workup and return to this algorithm if negative for other diagnoses
                            • Yes
                              • Meets criteria for diagnosis of PID
                                • Meets Discharge Criteria for outpatient PID treatment
                                  • Yes
                                    • Follow Discharge Guidelines (see page 2)
                                  • No
                                    • Begin parenteral antibiotics (see page 2)
                                      • Admit
                        • Yes
                          • Consult GYN- off algorithm
                  • No
                    • Meets criteria for diagnosis of PID
                      • Meets Discharge Criteria for outpatient PID treatment
                        • Yes
                          • Follow Discharge Guidelines (see page 2)
                        • No
                          • Begin parenteral antibiotics (see page 2)
                            • Admit
        • No
          • Off algorithm Note: pregnant patients may still have PID

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