A 34-year-old woman presents to the GP with a 4-day history of offensive vaginal discharge, lower abdominal pain, and deep dyspareunia. On examination...

Question

A 34-year-old woman presents to the GP with a 4-day history of offensive vaginal discharge, lower abdominal pain, and deep dyspareunia. On examination, she has bilateral adnexal tenderness and cervical motion tenderness. Her temperature is 37.6°C. A pregnancy test is negative. She has an LNG-IUS in situ (inserted 2 years ago). She asks whether the IUS should be removed. According to BASHH guidance, which is the most appropriate advice?

Accepted Answer

Start antibiotics immediately - the IUS does not need to be removed routinely unless there is no clinical improvement after 48-72 hours of appropriate antibiotics

Answer

The IUS must be removed immediately before starting antibiotics

Answer

The IUS must be removed and she can never have an IUS again

Answer

The IUS is the cause of the PID and must be removed

Answer

Defer antibiotics until the IUS is removed

uk-drcog MCQ (SBA): PID with IUS In Situ - Do Not Remove Routinely