A case of chlamydial pelvic inflammatory disease with edematous swelling and softening of the ovaries observed under laparoscopic surgery

Abstract

Sexually transmitted diseases involving chlamydia are increasing, and sterility as a chronic sequela of chlamydial infection appears to be on the rise. Prevention of progression and sequelae is possible if appropriate antibacterial drugs are given during the early period of infection. However, many cases develop so-called silent pelvic inflammatory disease (silent PID), which progresses asymptomatically from cervicitis to abdominal cavity infection. While recently performing laparoscopic ovarian drilling to treat a patient with polycystic ovary syndrome (PCOS), we observed edematous swelling and softening of bilateral ovaries. Two months later, the patient developed a large quantity of ascites and a high CA125 level. Therefore, the patient underwent further investigation and antibacterial therapy was started. The ascites disappeared soon after antibacterial treatment was given. The clinical test results and the typical filmy adhesions around the adnexa observed on subsequent laparoscopy confirmed that this patient's clinical course was due to chlamydial PID.