30yr/f p3/all ftnd l.d.3 yr h/o t.l. before 2 yr c/o pain lower abdomen since 2 days with white discharge p/v, mensus 2 times/month with heavy flow since 1 month USG-bilateral parametritis with PID, ? cystitis



P/A, p/s,P/v- Findings??Temp.. Invg-Hb, DC,TLC,UR-r/m & c/s,high vaginal swab c/s If temp >101, severe pain abd, CMT +ve, High Tlc count den admission sd b done IV Broadspectrum antibiotics ( Ceftriaxone/ cefotaxime, Metron, Genta/amikacin- if RFT Normal) f/b Oral drugs- cipro/ oflox, Doxy, Metro Tab.Lyser-D, proteins, Multivitamin, Iron support. For heavy flow Tranexa tab., Ocpill 3-6 cycles.

urine r&m c&s vaginal swab examination cbc inj monocef 2gm bd inj amikacin 500mg od urine alkaliser put on Dueluton od for 3 cycles Clinton vaginal passer abstnance till recovery deworming plenty of fluid

urine for culture n sensitivity. start iv broadspectrum antibiotics, antifungals and anti-inflammatory. iron and multivitamin supplements.

Broadspectrum antibiotics with antispasmodic will provide relief but urine examination is important as pain lower abdominal

She needs broad spectrum antibiotics div pipzo tid+Iv inj clindamycin tid+iV amika bd for at least five days. With any pain killer. For vaginL discharge, v can Give vaginal pessary containing clotrimazole+clindamycin

broad spectrum antibiotics , with anti inflammatory with seratiopeptidase , for menorrhagia tab . norethisterone 15mg per day taper the dose gradually to 5 mg per day , tab tranexa 500mg bid for 5 days .

choice is yours regarding antibiotic. Inj. placentrx 1amp daily for 14 days will do synergistic action with antibiotic.

do bsl fasting n pp. treat with doxy 100mg bd.tab metrogyl 400mg bd.tab azithromycin 1gm sd .localy candid cl vaginal pessories.if blood suger high control it.treat pid mensrual problems n cystitis subsides automatically

urine for culture sensitivity, in the meantime to start doxy 100mg bd for 14 days and metronidazole 500mg tid for 7days.and for husband FAS kit..and after 2weeks to do pap smear..n if symptoms don't subside she should be started on iv antibiotics inj clindamycin 900mg iv 8th hrly and inj Gentamycin 3-5mg/kg daily once

Usg report do not diagnose PID .History and local examination will confirm it.white discharge is not abnormal after 3 ftnds.As the endometium is only 6 mm thick no pathology in uterus.uti is more probable and mentrual cycle regulation can be done with 3 month Oc pills

I too agree with my colleagues. But partner also has to be treated for minimum 3 weeks.With this infection he too can have prostatitis and epididymoorchitis.

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