Gonococcal Pelvic Inflammatory Disease: Placing Mechanistic Insights Into the Context of Clinical and Epidemiological Observations

J Infect Dis. 2021 Aug 16;224(12 Suppl 2):S56-S63. doi: 10.1093/infdis/jiab227.

Abstract

While infection by Neisseria gonorrhoeae is often asymptomatic in women, undetected infections can ascend into the upper genital tract to elicit an inflammatory response that manifests as pelvic inflammatory disease, with the outcomes depending on the intensity and duration of inflammation and whether it is localized to the endometrial, fallopian tube, ovarian, and/or other tissues. This review examines the contribution of N. gonorrhoeae versus other potential causes of pelvic inflammatory disease by considering new insights gained through molecular, immunological, and microbiome-based analyses, and the current epidemiological burden of infection, with an aim to highlighting key areas for future study.

Keywords: Neisseria gonorrhoeae; cervicitis; endometrial infection; endometritis; gonorrhea; neutrophil; oophoritis; pelvic inflammatory disease (PID); salpingitis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Chlamydia Infections / complications
  • Chlamydia Infections / epidemiology*
  • Endometritis / microbiology
  • Endometrium / microbiology
  • Endometrium / pathology
  • Fallopian Tubes / microbiology
  • Female
  • Gonorrhea / diagnosis
  • Gonorrhea / epidemiology*
  • Humans
  • Neisseria gonorrhoeae / isolation & purification*
  • Pelvic Inflammatory Disease / diagnosis
  • Pelvic Inflammatory Disease / epidemiology*
  • Pelvic Inflammatory Disease / microbiology