Which statement best describes PID symptoms?

• A. It can be asymptomatic, and may include fever, pelvic pain, and vaginal bleeding
• B. It is always symptomatic with fever and discharge
• C. It presents only with urinary symptoms
• D. It is always asymptomatic

Answer: (A)

Pelvic inflammatory disease can show up on a spectrum from no symptoms to clear, noticeable signs. The statement that best describes PID symptoms recognizes this variability: it can be asymptomatic, and may include fever, pelvic pain, and vaginal bleeding. This captures both the possibility of no symptoms and the range of signs that can occur with the infection spreading upward from the cervix. Fever can occur with infection, pelvic pain is a common local sign, and abnormal vaginal bleeding can happen with endometritis or cervical involvement. Because not all patients have fever or discharge, and some have only mild or non-specific symptoms, this description fits best. PID is not limited to urinary symptoms, and it is not always asymptomatic, so the other ways of describing it don’t fit as well.