In pelvic inflammatory disease, the patient has symptoms of nausea, vomiting, and fever, lower abdominal pain, and dysuria; however, she most likely will also have an abnormal vaginal discharge and/or abnormal uterine bleeding, dyspareunia. On physical examination, the patient will have cervical motion tenderness and may have adnexal tenderness or even an adnexal mass. In this scenario, the patient has a normal pelvic exam without cervical motion tenderness, which makes the diagnosis of pelvic inflammatory disease less likely.
Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2003 ed., Pelvic Inflammatory Disease. George T. Danakas M.D. Copyright © 2003 Mosby, Inc. pg. 613
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