An 18-week pregnant woman presents with right iliac fossa pain, cervical motion tenderness, and fever of 38 degrees Celsius. Pelvic ultrasound excludes an adnexal mass and appendicitis is considered unlikely. Management should involve:

• A Oral cefixime and azithromycin as an outpatient with review in 72 hours
• B Immediate laparoscopic drainage of the cul-de-sac
• C Hospitalisation for intravenous antimicrobial therapy covering both gonorrhoea and chlamydia ✓
• D Expectant management with analgesia until delivery, then full workup

Explanation

All pregnant women with suspected PID require admission for parenteral therapy because maternal and fetal morbidity is high, oral regimens achieve unreliable levels, and differential diagnoses such as appendicitis and septic abortion need close observation. CDC 2021 explicitly recommends hospitalisation in pregnancy. Outpatient oral treatment, surgical drainage without indication, and deferring treatment all expose the pregnancy to continuing infection, preterm labour, and fetal loss.

Reference: CDC Sexually Transmitted Infections Treatment Guidelines, 2021 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.