Book Review

Pelvic Inflammatory Disease

N Engl J Med 1993; 329:145-146July 8, 1993

Article

Pelvic Inflammatory Disease
Edited by Gary S. Berger and Lars V. Westrom. 204 pp., illustrated. New York, Raven Press, 1992. $70. ISBN: 0-88167-921-6

With the current epidemic of sexually transmitted diseases and the worldwide problems of genital tract infection in women, this is a timely and important textbook. As pointed out by Dr. Ledger in his foreword, “This is the first text solely devoted to the subject of pelvic inflammatory disease in more than seventy years.” The importance of this subject and the consequences of this disease for women alert us to the need for organized writings on this topic.

The book is substantially greater in scope and detail than previous textbooks and isolated chapters on the subject in other books. The strengths of this textbook are the clear and concise manner in which several chapters are written and the information contained in chapters that deal with the consequences of pelvic inflammatory disease.

The book starts off slowly. The first two chapters could have been expanded and could have placed more emphasis on the definition and epidemiology of pelvic inflammatory disease. The second chapter summarizes much of the current information from England and the United States but does not give an overview of the importance of this problem. This minor weakness is certainly compensated for by subsequent chapters dealing with the pathogenesis, diagnosis, and consequences of pelvic inflammatory disease in women.

The chapters by Patton and Rice and Westrom on the microbiology and pathogenesis of pelvic inflammatory disease are superb. They bring the reader up to date on new findings on causes and on the sequelae of infections with specific microbial agents. The chapters on diagnosis and differential diagnosis should be read by all students, residents, and health care workers.

There is a clear and concise presentation of the clinical findings that alert the clinician to the diagnosis of pelvic inflammatory disease. The detailed discussion of laboratory tests and imaging techniques is up to date and clinically relevant. There is also a section devoted to invasive diagnostic techniques.

The section on treatment is a weak spot. I expected it to cover not only antibiotic therapy but also other types of management. The discussions of interventional radiologic techniques and surgical techniques, including laparoscopy and laparotomy, need more space. These aspects of therapy are presented in a very limited manner; I believe that they do not give the clinician as adequate a background as other sections. One of the book's strong points is that it enables readers to find information on the consequences of pelvic inflammatory disease in a single place.

I recommend this book to all health care providers who examine and treat women. It offers concise, readable, and important information about the diagnosis and management of pelvic inflammatory disease. It puts into context the impact that this disease has on women in their reproductive years, and it alerts clinicians to be aggressive in the diagnosis and management of this disease.

David A. Baker, M.D.
State University of New York Health Science Center, Stony Brook, NY 11794