Commonly used diagnostic criteria for pelvic inflammatory disease have poor sensitivity for plasma cell endometritis

Centers for Disease Control and Prevention (CDC) guidelines for diagnosis of pelvic inflammatory disease (PID) may not identify all women with PID. Researchers performed biopsies of the uterine wall on 132 women with symptoms of PID and tested women for sexually transmitted diseases. Biopsy samples that showed plasma cell inflammation were declared to be evidence of PID. CDC diagnostic guidelines identified only 36% of the PID cases, compared to diagnoses based on the presence of plasma cell endometritis. CDC guidelines may need to be revised for high-risk patients by broadening the scope of symptoms to include any pelvic pain or abnormal test result. Such a revision would cause more patients to be tested and greater costs to be incurred, but might prevent ectopic pregnancies and infertility caused by untreated PID.