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Spotting and bleeding between periods. Us show mild fluid collection in pouch. Prescribed Ornilox. PID or something else?

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please help! today i had ultrasound of pelvic cos I have spotting and bleeding between periods for the last 3 months. It says Mild fluid collection noted in the pouch of XXXXXXX measuring 18mm. Sonographic features above are inline with PID. So i got antibiotics Ornilox for 5 days.other report:
Uterus appears normal in size shape and echo texture measruing 64x39x43 mm with a clear endometrial stripe measuring 7mm. Both ovaries are visualised and they appear normal. Urinary blader wall apperas normal well distended with echo free urine.
I have no other symptops. Period somehow regular, but it actually comes sometimes 7 days late . I have no itching, pain during sex, or smelly discharge. I feel a small abdominal cramps but often unnoticed, = thinking it is normal.
I am now so scared. Does it really mean PID? Or any other infection?
is the dosage right to treat PID if I have it?
Can it be any other infection?
I want to have a baby and I cannot get pregnant, we tested with my partner in September for STI and both negative and i cannot get pregnant.
Posted Wed, 5 Jun 2013 in General Health
Answered by Dr. Prasad Akole 1 hour later
Dear XXXXXX, welcome to XXXXXXX
I am Dr. Prasad Akole and glad to address to your query here.

Your pelvic organs are sonographically normal. Only the fluid collection in the pouch of XXXXXXX is abnormal (not normally present).

As you have menstrual irregularity and ? infertility so far, It is likely a PID (pelvic inflammatory disease).

Such fluid in the POD can collect as ascitis bur will not cause menstrual problems.
Ornilox for 5 days may not be sufficient if the infection is bad.

Do you get any fever, nausea, fatigue, pain in the lower abdomen, loose motions, bladder problems?
Have you undergone complete gynaec evaluation?

I would advise to have a complete evaluation (physical and blood work) and a gynaec opinion to look faor any XXXXXXX findings.

If it is anything else can be decided only on such thorough evaluation. Ask if fluid can be aspirated on colposcopy for microscopy and culture.

A CT scan may be advised.

I would be glad to answer any other query. Please keep me posted at

Take care. Good Luck!
Above answer was peer-reviewed by
Follow-up: Spotting and bleeding between periods. Us show mild fluid collection in pouch. Prescribed Ornilox. PID or something else? 8 minutes later
Hello Dr XXXXXXX Akole,

no i have no fever, no nausea, no fatique, no pain in the lower abdomen, not even when you press on it, no loose motions or bladder problems.
I am currently in uganda and i had no other examinations, can i go on for blood test? however they cannot specify the type of bacteria.. :-(
I can see if I can get some smear.

What should CT scan show?
Also if to get more antibiotics, how many days I should get them for?

I really feel absolutely normal, even during the spotting/bleeding between periods I feel no pain or cramps... only my actual period is very heavy and last 3-4 days.
Answered by Dr. Prasad Akole 10 minutes later
Ok. I see. If no fever and no other significant symptoms, I would advise to wait for antibiotics till you get some evidence of infection.

You can get basic blood tests done CBC, urea, creatinine, LFTs, urine routine/microscopy.

Do not take antibiotics without adequate gynaec evaluation. Half hearted antibiotics may induce resistance or mask findings. Duration depends on symptoms type of bacteria etc.

A CT scan of the abdomen and pelvis can better define all the pelvic structures and some features not seen on sonography and more precisely.

It may be fluid from other causes like ascitis, low proteins etc.

I hope this helps. Watch for fever, nausea, PV discharge, pain etc.
The picture is not very classic of PID.
Above answer was peer-reviewed by
Follow-up: Spotting and bleeding between periods. Us show mild fluid collection in pouch. Prescribed Ornilox. PID or something else? 5 minutes later
ok i already took one pill tonight... I got really scared..
So simple CBC, urine, should define it?
What about the bleeding between periods?

Answered by Dr. Prasad Akole 2 days later
I understand you are scarred. However I strongly recommend you get evaluated and determine the cause. Fluid in the pouch of XXXXXXX suggests pelvic inflammatory disease, however this can be related to other conditions too.

As you do not have any other ominous symptoms we could wait before starting antibiotics.

You could consider complete blood count, urine routine and microscopy, renal and kidney profile. The test will give us directions to identify the cause. CT scan of abdomen and pelvis if possible can provide more clarity about your abdominal organs. You can consider getting the aforementioned tests under the guidance of healthcareprovider.

If the bleeding is not severe and what you have is only spotting, you can observe a few days before option to treat it by your healthcare provider.

Let me know if you need further assistance.

Above answer was peer-reviewed by
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