Management of acute gynecological infections

Strube F., Kiesel L.

Abstract

Background: Infection-related symptoms are a frequent challenge in emergency gynecological treatment. Objective: This article aims to provide clinicians with a summary and an assessment of the various guidelines regarding the diagnostics and therapy of acute gynecological infections as well as the indications and implementation of postexposure prophylaxis. Methods: The recommendations of leading institutions were reviewed and where necessary the cited evidence was analyzed. The database of the Center for Biotechnology Information, PubMed, was searched using the terms pelvic inflammatory disease (PID), salpingitis, endometritis, cervicitis, bartholinitis, Bartholin’s cyst, Bartholin’s abscess, human immunodeficiency virus (HIV), postexposure prophylaxis (PEP), genital herpes and herpes simplex virus type 2 (HSV-2). Results: When PID is suspected treatment should be carried out after exclusion of an extragenital etiology of symptoms. After potential exposure PEP can prevent infection, especially after exposure to HIV and is indicated depending on the HIV status of the contact person and the type of contact. Of the various effective techniques for draining a Bartholin’s abscess, the one with the least risk of recurrence is not known. The seroprevalence of HSV-2 is approximately 15 % in German women and acyclovir can be used for treatment in different situations. Discussion: Effective management of infection-related gynecological emergencies can lead to a rapid cure of infections, prevent complications and sequelae while PEP can prevent infections and diseases. There are insufficient data to recommend a particular treatment modality for Bartholin’s abscesses.