Introduction Pelvic inflammatory disease (PID) is a well known complication of infection with Chlamydia trachomatis ( C.trachomatis). The knowledge of Mycoplasma genitalium( M.genitalium) and its role in PID is relatively limited. In this study we report on the proportions of C.trachomatis and M.genitalium attributable to PID from an ongoing study of laparoscopically diagnosed cases of PID.

Method Women seeking care at the emergency service at the Department of Obstetrics and Gynaecology at Malmo University Hospital in Sweden from 2004 through the mid of 2012 with clinically suspected PID, who underwent diagnostic laparoscopy, were eligible. Specimens from the cervix/and or vagina together with abdominal fluid were collected and analysed for pathogens such as C.trachomatis and M.genitalium.

Results In all, 208 women were included and 123 (59.1%) were diagnosed with PID at laparoscopy. C.trachomatiswas present in cervix and/or abdominal fluid in 29/123 (23.6%) of these cases. M.genitalium was present in cervix and/or abdominal fluid in 5/123 (4.1%) cases of PID. In three of these cases M.genitalium was positive only in cervix and there was a dual infection with C.trachomatispositive in the abdominal fluid. Two PID cases were M.genitalium positive only, (2/123, 1.6%). A significantly declining trend for C.trachomatis PID was observed (42.8% - 11.5% p = < 0.001). The prevalence of C.trachomatis and M.genitalium was 2.8% and 2.1% respectively in 5519 women tested from 2003 to 2008 in the same clinic.

Conclusion The over all proportion of PID attributable to C.trachomatis was 23.6% but over the study period a significantly declining trend was seen. The proportion of PID attributable to M.genitalium (1.6%) was significantly lower considering the prevalence to be in the same range as for C.trachomatis, suggesting that M.genitalium was a less aggressive pathogen in terms of clinical manifestations of PID.