A 26-year-old sexually active woman presents with lower abdominal pain, mucopurulent cervical discharge, and cervical motion tenderness. She is haemodynamically stable. According to CDC 2021 guidelines, what is the minimum diagnostic criterion for initiating empiric PID treatment?
- A Cervical motion tenderness PLUS elevated CRP and ESR
- B Positive NAAT for Neisseria gonorrhoeae or Chlamydia trachomatis
- C Cervical motion tenderness alone ✓
- D Laparoscopic confirmation of salpingitis
Correct answer: C. Cervical motion tenderness alone
Explanation
The 2021 CDC guidelines state that empiric treatment for PID should be initiated in sexually active young women with uterine tenderness, adnexal tenderness, OR cervical motion tenderness when no other cause is identified. The diagnostic threshold is deliberately low because the consequences of untreated PID (infertility, ectopic pregnancy, chronic pelvic pain) outweigh the risks of over-treatment. Positive STI testing supports but is not required for diagnosis.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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