Laboratory evaluation

A. Laboratory studies may be entirely normal. An elevated leukocyte count does not distinguish PID from other diagnoses.

B. Nonculture tests (eg, Chlamydiazyme, Sure Cell Chlamydia) have good specificity, although sensitivity is less than optimal. Cervical cultures for gonorrhea or Chlamydia require 3-7 days for results and are highly sensitive.

C. Human immunodeficiency virus (HIV) and syphilis testing are also recommended for patients with suspected PID.

D. Pelvic ultrasonography can detect pelvic abscesses. Laparoscopy is the "gold standard" for diagnosing PID, and it is recommended when the diagnosis is unclear or when the patient fails to improve.

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